On November 2, CMS finalized the 2017 Physician Fee Schedule. The ruling recognizes the importance of primary care by improving payment for chronic care management and behavioral health services. It also finalizes the proposal to implement the Medicare Diabetes Prevention Program expanded model beginning January 1, 2018.
The annual Physician Fee Schedule updates payment policies, payment rates, and quality provisions for services provided in CY 2017.
Additional policies finalized in the 2017 payment rule include:
Primary care and care coordination - The rule finalizes revisions to payment for chronic care management, including payment for new codes for complex chronic care management and for extra care management furnished by a physician or practitioner following the initiating visit for patients with multiple chronic conditions. This finalized change is a significant update to the Physician Fee Schedule and will support primary care when and where patients need it most.
Mental and behavioral health - CMS is finalizing payments for codes that describe specific behavioral health services furnished using the psychiatric Collaborative Care Model, which has demonstrated benefits in a variety of settings. In this model, patients are cared for through a team approach, involving a primary care practitioner, behavioral health care manager, and psychiatric consultant. CMS is also finalizing payment for a new code that broadly describes behavioral health integration services, including payments for other approaches and for practices that are not yet prepared to implement the Collaborative Care Model.
Cognitive impairment care assessment and planning - CMS finalizes payment to physicians to perform cognitive and functional assessment and care planning for patients with cognitive impairment (e.g., for patients with Alzheimer’s). This is a major step forward for care planning for these populations.
The 2017 payment rule will also:
Finalize a data collection strategy for global services with significantly reduced burden for practitioners compared to the proposal
Finalize a change that will more accurately reflect local costs and significantly increase payments to practitioners in Puerto Rico
Enhance program integrity and data transparency in the Medicare Advantage program.
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