On Nov. 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the Medicare program final rule, which details revisions to payment policies included in the physician fee schedule and Quality Payment Program (QPP) for 2022. The AASM will perform a full analysis of the final rule and will share its potential impact on policy and reimbursement for sleep-specific services.

A few key highlights include:

  • The 2022 conversion factor was finalized at $33.5983, a 3.71% decrease from the 2021 conversion factor. The Consolidated Appropriations Act previously provided a temporary 3.75% payment increase for 2021, which is now expiring. The remaining payment reduction due to budget neutrality will be implemented for 2022.
  • Several refinements were made to policies for the following:
    • Split (or shared) evaluation and management (E/M) visits
    • Critical care services
    • Services furnished by teaching physicians with residents
  • Services temporarily added to the Medicare telehealth services list will remain on the list until Dec. 31, 2023, which will allow for additional data collection to determine whether any of the services should be permanently added to the list.
  • The current definition of interactive telecommunications system for telehealth services is being amended.
  • The section of the Consolidated Appropriations Act, which authorizes Medicare to make direct payments to physician assistants for professional services furnished under Part B, is being implemented beginning Jan. 1, 2022.

Read the CMS physician payment press release and fact sheet for more details. AASM members can send questions about the final rule to coding@aasm.org.

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