Online Training Course

Prod ID: 344
Highlights of CMS Proposed Changes to PFS

Get a head start on strategic planning for next year with details on the proposed changes to the 2023 Physician Fee Schedule (PFS). This information will help you make informed decisions and guide your practice in a positive direction.

CEUs

1

Length

45 min

Price

$99.00

The Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (PFS) rule for 2023 in July. Gain the facts on the proposed changes and receive information on how to submit comments prior to the final rulemaking.

Key points covered:

  • The expiration of the 3% PFS increase means providers can expect a decrease in PFS in 2023. Possible reweighting of MEI cost shares could also change to payments among PFS services.
  • Other proposals in review will involve split or shared E/M visits, changes to Medicare telehealth, and new HCPCS codes and valuation for chronic pain management.
  • E/M changes could include new descriptor times, revised interpretive guidelines for levels of MDM, and choice of MDM or Time to select code level.

Shawntea Gordon

MBA, CMPE, CMOM


Shawntea "Taya" Gordon is a subject matter expert in healthcare compliance, organizational governance, process optimization, and revenue cycle management; a Business Analyst and Revenue Cycle SME, H4 Technology, LLC, and Owner, ITS Healthcare, LLC. She has held senior-level executive management positions in private practices, collaborative institutes, and national care coordination organizations, and now educates and consults on all areas of healthcare operations. 

Taya teaches a range of topics including performance improvement, quality improvement, risk reduction, and the shift to value-based payment methodologies. She is also a Business Analyst and Rev Cycle SME for H4 Technology, LLC, a Data Management Software as a Service (DMSaaS) organization providing services to hundreds of providers across the nation. A proud member of the MGMA's Government Affairs Council and E/M Workgroup, Taya recently co-authored the new publication Revenue Cycle Management: Don’t Get Lost in the Financial Maze.

Taya received her Executive MBA in Healthcare Management at Creighton University where she graduated Suma Cum Laude. Taya is the current President of the HIMSS Nebraska Chapter, former Chair of the Membership and Corporate Development Maryland MGMA Chapter, and was recognized in 2019 by Midland’s Business Journal as a ‘40 Under 40’ Executives & Entrepreneurs Award Recipient.

This session prepares medical practice leaders to prepare for CMS reimbursement changes expected to impact the practice in 2023. 

 Basic knowledge of Medicare reimbursement is beneficial.

 

New revisions are proposed to coding and documentation framework, including E/M code updates from the AMA to reduce administrative burdens. Review 2023 CPT code descriptors like new times, revised interpretive guidelines for level of MDM, and choice of MDM or time to select code level, and the elimination of history and exam to determine code level. If finalized, there would instead be a requirement for a medically appropriate history and exam. And more...

  • Replacement of history and exam to determine code level with a requirement for a medically appropriate history and exam.
  • Telehealth Services have several proposals related to Medicare telehealth services that involve process transitions at the end of the PHE.
  • Learn what's happening in 2023 with behavioral health services, chronic pain management and treatment services, opioid treatment programs, audiology and dental/oral health services.
  • Changes to colorectal screenings include reducing the minimum age payment limitation to 45 years.

 

Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

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Comments from past participants:

“Important information for the coming year - good starting points to discuss with providers."

“Excellent! Lots of great information and good insights for preparing for the new year."

“It was extremely informative of the upcoming proposals to the fee schedule."

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