On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule Final Rule. The biggest takeaways impacting Medsien clients are that care management services are here to stay – CMS has significantly increased the reimbursement and added additional codes and categories within care management services. They have expanded the code set for care management to include Chronic Care Management (CCM) and Complex Chronic Care Management (CCCM), and updated codes for Principal Care Management (PCM) services.
Also, effective January 1, 2022, CMS has introduced a new category of digital health services – Remote Therapeutic Monitoring (RTM) – to complement the existing suite of Remote Patient Monitoring (RPM) codes covered under Medicare. The new codes are intended to expand the scope and reach of digital health technologies to reimburse the monitoring of non-physiologic data. The new RTM codes broaden Medicare reimbursement for remote monitoring beyond the existing Remote Physiologic Monitoring (RPM) codes and represent one of the latest advancements to modernize reimbursement for digital health. The RTM family includes three practice expense (PE)-only codes and two codes that include professional work. Medsien is excited to be expanding our services into RTM programs. Look for more information in early 2022.
Additional codes and new reimbursement for these RTM services have been added. And CMS’ new rates for remote patient monitoring (RPM) have been announced as well. Another interesting trend to note is that both PCM and RTM services apply more to specialty providers, showing that Medicare is moving into reimbursement and support for a broader range of providers.
CMS is clearly invested in the clinical and financial benefits of care management services for the coming year and going forward. There’s no better time to add care management programs to your practice. Or, to maximize the benefits and efficiency of your existing care management programs by improving the quality and efficiency of your program.
We will outline expected changes impacting codes related to Medsien’s services for 2022 below, and will follow up in early 2022 with an update when final changes for the year go into effect.
Ongoing trend – Medicare committed to the growth of care management
This continuous trend of CMS investment in care management is likely to continue. Each year since CMS initially added reimbursement for care management in 2015, they’ve continued to triple down on it, showing a clear interest and belief in the value of care management for patients. Annually adding new codes, increasing reimbursement and easing requirements – clearly shows the trend towards more and more investment and commitment to these programs.
The bottom line is that this is a good time for care management in general, and for practices that have already adopted good care management programs. But it’s really the perfect time to add a robust care management program to your practice. Medsien’s top of the line, turn-key, highly sophisticated care management programs are fast and easy to implement and run, require no administrative or staffing burden nor any upfront costs to the practice. For more information on our programs and services go to www.medsien.com.
Medsien is the leading provider of scalable remote care management for a quality patient experience. Hundreds of organizations trust Medsien’s unparalleled technology solutions to implement exceptional remote care management programs, personalize every interaction, and improve the lives of the people who need it most. Based in San Francisco and venture-backed by top-tier investors, Medsien was founded to reimagine remote care management. Visit medsien.com for more information.
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On November 2, 2023, CMS released its 2024 Final Physician Fee Schedule on policies related to remote care management. At the time of the release, Medsien provided a full summary of 2024 updates and changes that would impact Medsien clients and programs related to remote care management. Here we offer a bit more information to highlight specific, important changes for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).