Every summer, CMS publishes its proposed new physician payment and coding change guidelines for the coming year. November 1, 2023, CMS will publish its final rule confirming or changing issues from the proposed rules. In some circumstances, provider comments can influence CMS to deviate from their original proposed guidelines. It is very important for providers and staff to know what items in the proposed rule will move forward to 2023 and to know what CMS has decided not to move forward on in 2024. The proposed rule issues that were not implemented for 2023 may identify issues still being considered for 2024. This year, there are significant changes to EM services, splits/shared care, remote patient monitoring (RPM), complex chronic care management (CCM), etc., that will require a complete change in the way services are coded outside of the office setting.

Learning Objectives:-

• Correct coding of EM services outside of the office setting
• New Medicare Clinical Quality Measure (CQM) collection type for ACOs under the Alternative Payment Model (APM) Performance Pathway (APP)
• CMS’s new conversion factor for 2024 affects your bottom line
• Changes to colorectal cancer screening guidelines
• How shared care will change or not change for 2024
• Identify new telehealth services available after the end of PHE
• Consider how the role of clinical psychologists, clinical social workers, professional licensed counselors, and licensed marriage and family therapists will improve access to behavioral health services
• New codes and strategies for chronic pain management
• Understand new payment methodology and codes for Methadone treatment drugs
• Review finalized guidelines for patient access to audiology services and dental oral health care
• Understand new payment and classification of wound care management products

Areas Covered:-

• The new conversion factor for 2024
• New Medicare Clinical Quality Measure (CQM) collection type for ACOs under the Alternative Payment Model (APM) Performance Pathway (APP)
• New EM codes and code categories outside of the office setting
• New times associated with EM codes
• New prolonged service G codes for Medicare patients
• Split/Shared care
• Colorectal screening guidelines
• Updated telehealth availability
• Chronic care management (CCM)
• Availability for patient treatment by clinical psychologists, clinical social workers, professional licensed counselors, and licensed marriage and family therapists
• Payment for drugs for methadone treatment
• Expanded access to audiology and dental/oral health services
• Possible changes to “Skin Substitutes” in 2024
• 2024 CPT E/M Changes
• Deleted Codes and Categories
• Combined Categories
• Home/Residence Services Changes
• CMS General Prolonged Services Guidelines
• AMA versus CMS Time Calculations for Prolonged Service
• CMS Prolonged Service Confusion
• CMS General Prolonged Services Guidelines
• Hospital/Observation, Nursing Facility
• Guidelines Controversy
• Colorectal Cancer Screening
• Telehealth
• Chronic Pain Management
• G0323 BHI
• Behavioral Health Services
• Opioid Treatments
• Methadone Payment Policy
• Opioid Treatment Programs
• Additional Rules
• Audiology Services
• Dental & Oral Health Services
• KX Modifier Thresholds
• Discarded Drugs
• RHC and FQHC
• Revaluing Global Surgical Days
• Live Q&A session

Who Should Attend:-

• Healthcare Executives – CEOs, CFOs, COOs
• Healthcare Providers
• Billing Staff 
• Coding Staff
• Office Managers
• Auditors
• Insurance payers
• Coders
• Accounts payable staff
• Denial management staff
• Payment policymakers
• Denial resolution teams
• Compliance officers
• Clinic Managers
• Physician and Non-physician Practitioners
• Nurse Practitioners
• Credentialing & Enrollment Staff
• Insurance Company Claims Reviewers