In case you missed it, last week CMS issued the proposed 2025 Physician Fee Schedule (PFS).
There's a ton in the proposed rule, but some areas to highlight:
* CMS is proposing to the lessons learned in over a decade of Innovation Center advanced primary care models to establish a new, advanced primary care management (APCM) payment and coding under the PFS. These codes describe team-based advanced primary care services, with adjustments for patient medical and social complexity, and are tied to primary care quality measures
* Based on the Innovation Center's Million Hearts® Model successes in reducing mortality, new proposed coding and payment for cardiovascular risk assessment and management
* Proposing to strengthen the Medicare Shared Savings Program through a health equity benchmark adjustment to promote ACO participation in underserved areas
* For the first time, CMS is proposing to allow eligible Shared Savings Program ACOs with a history of success in the program access to an advance on their earned shared savings, known as prepaid shared savings, to encourage investment in staffing, health care infrastructure, and additional services for people with Medicare, such as nutrition support, transportation, dental, vision, hearing, and Part-B cost-sharing reductions
* Proposing new payment for practitioners who are assisting people at high risk of suicide or overdose, new payment and coding for use of digital tools that further support the delivery of specific behavioral health treatments, and new coding and payment to make it easier for practitioners to consult behavioral health specialists
* Proposing that payment can be made for certain dental services associated with dialysis treatments for end-stage renal disease
* Proposing new payment for caregiver training services related to direct care services and supports
...and so much more. The 60 day comment period ends Sept 9th, don't forget to submit your comments.
CMS has released the CY 2025 Physician Fee Schedule proposed rule, which includes new policies to advance #HealthEquity, support whole-person care, strengthen primary care, and expand access to behavioral and oral health care. Learn more here: https://go.cms.gov/4eYtKrJ
