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CMS Medicare Physician Fee Schedule for CY2017 Proposed Rule Released

Jul 22, 2016

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-07-2.html

On July 7, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2017.

Hi-lights:

  • Proposing modifications to the Medicare Shared Savings Program to
    • Update the quality measures set and align with the proposals for the Quality Payment Program
    • Changes to take beneficiary preferences for ACO assignment into consideration
    • Changes that would improve beneficiary protections when ACOs are approved to use the skilled nursing facility (SNF) 3-day waiver rule
  • Establishes new Evaluation Codes for Physical and Occupational Therapy
    • 3 levels but with no differentiation in reimbursement
    • “No gaming” of codes to influence reimbursement
    • Effective 1/1/17
    • Stay tuned for more details and CMS feedback
  • Telehealth Improvements but no provisions for Therapy Professionals at this time

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