Health Law Advisor

The Centers for Medicare & Medicaid Services (CMS) issued a final rule on November 1, 2018 that updates physician fee schedule (PFS) payments for calendar year (CY) 2019 and finalizes several policies. The final rule includes amendments to the regulations promulgated under Section 216 of the Protecting Access to Medicare Act of 2014 (“PAMA”) intended to increase the number of clinical laboratories that qualify as an “applicable laboratory” for reporting purposes; specifically (1) removal of payments received from Medicare Advantage (MA) Plans for determining ...

Providers, take note: the Chronic Care Management (CCM) CPT Code 99490 is now payable by the Centers for Medicare & Medicaid Services (CMS). Effective January 1, 2015, the Medicare program began making payments under the Physician Fee Schedule (PFS) for certain non-face-to-face management and care coordination services provided to beneficiaries covered under the traditional Medicare fee-for-service program. CCM services include, but are not limited to, development and maintenance of a plan of care, communication with other treating health care professionals, and ...