The final Physician Fee Schedule rule for 2015, published by CMS on Oct. 31, brings with it a number of changes that physicians and practice managers need to understand about chronic care, telehealth and meaningful use.
The final rule establishes among its major provisions a chronic care management payment rate of $40.39 that can be billed up to once per month per qualified patient. CCM services include development and revision of care plans for patients, communication with other treating health professionals and medication management.
[See also: HHS launches $840M in new IT incentives]
CMS is requiring physicians to use electronic health records to be reimbursed for CCM, but practices are allowed to use either 2014 or 2011 versions of certified technology.
"We continue to believe that it is necessary to require the use of EHR Technology that has been certified under the ONC Health IT Certification Program as requisite for receiving separate payment for CCM services, to ensure that practitioners have adequate capabilities to allow members of the interdisciplinary care team to have timely access to the most updated information informing the care plan," wrote CMS officials. "However, we also agree with commenters who expressed concern that requiring the most recent edition of EHR certification criteria could be an impediment to the broad utilization of the CCM service."
[See also: Practices buried under MU 'avalanche']
CMS also stipulated that certain services can be furnished to Medicare beneficiaries via telehealth: annual wellness visits, psychotherapy services and prolonged evaluation and management services.
In addition, the 1,185-page rule includes new details on electronic reporting of Clinical Quality Measures under the EHR Incentive program. The CY2014 PFS final rule required eligible professionals to report CQMs using the most recent version of the electronic specifications and to have EHR technology that is tested and certified to handle those specifications. In CY 2015, EPs will not be required to ensure that their EHR technology is recertified to the most recent version of the electronic CQM specs.
CMS "received feedback from stakeholders regarding the difficulty and expense of having to test and recertify CEHRT products to the most recent version of the electronic specifications for the CQMs. Although we still believe EPs should test and certify their products to the most recent version when feasible, we understand the burdens associated with this requirement."
CMS added this caveat, however: Although the agency is not requiring recertification, EPs must still report using the most recent version of the electronic CQM specs.
A version of this story first appeared on Medical Practice Insider.
