On Monday, Aug. 3, the Centers for Medicare & Medicaid Services (CMS) announced the release of the proposed rule citing potential revisions to payment policies under the Medicare Physician Fee Schedule and other Part B Payment policies.

The proposed rule has the potential to impact the field of sleep medicine in a variety of ways.

Key points in the proposed rule that may affect sleep medicine include:

  • The PFS conversion factor for Calendar Year (CY) 2021, which is being adjusted for budget neutrality, is proposed to decrease significantly from $36.09 to $32.26.
  • CMS is proposing to add several new codes to the Medicare Telehealth list on a Category 1 basis, while also proposing to add several codes to a temporary Category 3, during the current public health emergency.
  • There are several clarifications and proposals regarding the appropriate use of the remote physiologic monitoring codes.
  • New payment rates are being proposed for immunization services.
  • CMS is proposing to allow direct supervision to be provided using audiovisual technology through Dec. 21, 2021.
  • CMS is proposing to revalue code sets that rely upon or are analogous to office/outpatient E/M visits.
  • There are several proposals regarding ongoing professional scope of practice issues.

Public comments in response to the proposed rule can be submitted to CMS until 5 p.m. on Oct. 5, 2020.  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.

Get more coding and reimbursement resources from the AASM.