On July 29, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule citing potential revisions to payment policies under the Physician Fee Schedule (PFS) and other Part B payment policies. Highlights of the 2020 CMS proposed rule that will impact sleep medicine include:

  • The PFS conversion factor for calendar year 2020, which is proposed to slightly increase to $36.09
  • Proposed changes to code descriptors, decision making process, and reimbursement rates for evaluation and management codes and services
  • Potential modifications to physician supervision requirements for physician assistants
  • Additional modifications to documentation policies as a part of the “Patients over Paperwork” initiative
  • Solicitation of comments on opportunities for bundled payments, to improve accountability and increase efficiency in reimbursement for provision of care to the Medicare population

CMS is also soliciting comments on potential changes to the advisory opinion process to address stakeholder comments received in response to a request for information released in 2018 regarding the unnecessary burden created by the physician self-referral law (also known as the Stark Law).

Comments in response to the proposed rule can be submitted to CMS until 5 p.m. on Sept. 27. AASM staff will review the rule in its entirety and will work with AASM volunteers and leadership to submit comments on behalf of the AASM membership.

The proposed rule and a CMS fact sheet are currently available for review.