Description:

Staying upfront about regulatory modifications is paramount in an ever-shifting healthcare environment. The CMS Physician Final Rule for 2023, recently issued by the Centers for Medicare and Medicaid Services (CMS), is a pivotal document shaping the healthcare landscape in the United States. This regulatory update brings about significant changes impacting healthcare providers and patients. 

On November 1, 2022, CMS published its final rule after reviewing comments from the physician community confirming or changing issues from the proposed rule. CMS publishes its final rule for physician practices, outlining new policies, codes, coding guidelines, and fee schedules. This rule is a must for physician offices to read and be aware of all the changes within the CMS system. In 2021, the CPT and CMS final rule made sweeping documentation and reimbursement changes for office/outpatient E/M services.

Staying informed about the CMS Physician Final Rule 2023 is crucial for healthcare professionals and organizations. It is a testament to the commitment to continually improve patient care, promote efficiency, reduce administrative burdens for healthcare providers, expand telehealth services, and focus on quality reporting and value-based care models.

Webinar Highlights:

• CMS’s new conversion factor for 2023.
• CMS General Prolonged Services Guidelines.
• AMA versus CMS Time Calculations for Prolonged Service.
• Identify new telehealth services available after the end of PHE.
• Coding of EM Services Issues. 
• Non-F2F services were allowed to be reported to new and established patients.
• The Medicare Telehealth Services after the end of PHI.
• Expanded Medicare coverage for specific colorectal cancer screening tests to include a follow-up.
• Three things will occur at the end of PHE – some allowed services, some services, and others.
• Allow physical and occupational therapists, speech-language pathologists, and audiologists to provide telehealth services.
• CPM codes would be limited to beneficiaries in office or other outpatient or domiciliary settings.
• CMSs to reduce existing barriers to mental health issues and make greater use of services of behavioral health professionals, such as licensed professional counselors (LPCs) and Licensed Marriage and Family Therapists (LMFTs).
• Dental and Oral Health Services and Opioid Treatment Programs. 
• Establish system edits through the usual change management process to ensure HCPCS codes are billed with the modifier.
• Maintain and possible changes to the term “skin substitutes.
• Revaluing Global Surgical Days.
• Extend payment for telehealth services furnished by FQHCs and RHCs.

Why Should You Attend:

Significant changes to EM and prolonged services will require a complete change in how services are coded outside of the office setting and new times for determining extended services for Medicare patients.

Who Should Attend:

• Providers
• Coders
• Office managers
• Denial staff
• Audit staff 
• Reimbursement managers

Presenter Information:

Name: Jan Rasmussen

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 45 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992. As a member of the American Academy of Professional Coders (AAPC) Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributed to the development of the original AAPC’s independent study, university education programs, and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year.  Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination committee.

In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, and designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.

In previous consulting positions, she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/GYN, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.

Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37-provider, staff model HMO clinic.  As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.