The 2024 Medicare Physician Fee Schedule contains thousands of pages of rules for physicians to sift through, with only a portion obtaining to every specialty.
Rita Astani, president of anesthesia for Coronis Health, broke down some of the key rules chronic pain medicine leaders need to know in a Dec. 11 blog post from Anesthesia LLC.
Evaluation and management: Beginning Jan. 1, an add-on code will be made available for outpatient and office visits as an additional payment when clinicians are "the continuing focal point for all needed services or are part of ongoing care related to a patient’s single, serious condition or a complex condition," Ms. Astani wrote.
It remains unclear whether chronic pain physicians can bill this code. HHS has yet to provide a clear-cut indication on what it means by longitudinal care and whether such care can be provided by chronic pain practitioners, though there has been some indication by Medicare that the service can be provided by multiple specialties, in addition to primary care.
The final rule indicates that CMS will issue educational materials to clarify the rule, but chronic pain physicians have yet to receive an update, the post said.
Split/shared visits: For 2024, CMS is revisiting its definition of "substantive portion" of a split visit, Ms. Astani wrote. For billing purposes, the "substantive portion" means more than half of the total time spent by the physician or nonphysician practitioner performing the split visit or a substantive part of the medical decision-making.
The provision was finalized in response to public comments asking that CMS allow either time or medical decision-making to serve as the substantive portion of a split visit.
Telehealth: The 2024 final rule implements several new telehealth provisions, Ms. Astani wrote. The rule temporarily expands telehealth originating sites for services furnished via telehealth to include any site in the U.S. where the beneficiary is located at the time of the telehealth service. The continued coverage of telehealth expands until the end of 2024. CMS will permit the presence and immediate availability of the supervising practitioner through real-time audio and video interactive telecommunications.
The final rule continues to allow teaching physicians to use audio/video real-time communications technology to be present when the resident furnishes Medicare telehealth services in all residency training locations through the end of 2024. This virtual presence will meet the requirement that the teaching physician be present for the key portion of the service, the post said.