Medicare Part B Proposed Rule Updates Reimbursement, Extends Some Telehealth Authorities

On July 13, CMS released its annual Medicare Part B Physician Fee Schedule proposed rule.
Among other provisions, CMS proposes to:

  • Update reimbursement for Medicare Part B fee schedule services
  • Maintain certain telehealth services on the list of covered Medicare services to Dec. 31, 2023, so that there is a glide path to evaluate whether the services should be permanently added to the telehealth list.
  • Reimburse for audio-only telemental health services, provided an in-person service is is provided within six months
  • Take steps to expand participation in the Medicare Diabetes Prevention Program Expanded Model by reducing the benefit’s duration from two years to one (aligning the program with Centers for Disease Control and Prevention program design) and reworking the program’s benefit structure
  • Refine Medicare’s Quality Payment Program, proposing an increased performance threshold for incentive payment under Merit-based Incentive Payment System and outlining the first seven MIPS Value Pathway (MVP) measure sets.
  • Notably, despite the above steps that were proposed by CMS, certain broader waivers of geographic telehealth requirements will expire with termination of the current Public Health Emergency. Additional congressional action will be required.

CMS’ Notice of Proposed Rule Making (NPRM) also requested comment on vaccine administration payment and health equity data collection.
A draft PCC comment letter will be circulated to Executive Members for feedback in advance of CMS’ Sept. 13 deadline.
CMS resources:

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