2024 Medicare Advantage and Part D Medicare Final Rule

The Medicare Final Rule 2024, released on November 2, 2023, by the Centers for Medicare & Medicaid Services (CMS), impacts remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services reimbursed under Medicare. Key takeaways include RPM exclusivity to established patients, with a reinstated requirement after the Public Health Emergency (PHE). RTM offers flexibility without an established patient requirement. CMS clarified that certain remote monitoring codes need 16 days of data collection in 30 days, except for treatment management codes, providing practitioners greater flexibility. Only one practitioner can bill RPM/RTM for a patient in a 30-day period. Physical therapists and occupational therapists, along with assistants, can now bill RTM under general supervision. Concurrent billing with care management services is encouraged. There are billing restrictions during global surgery periods. Starting January 1, 2024, FQHCs and RHCs can separately bill Medicare for RPM and RTM services. RPM codes are excluded from MSSP primary care services. The Medicare Final Rule 2024 aims to enhance reimbursement, encourage flexibility, and maintain the integrity of primary care services. Stakeholder engagement is crucial for navigating operational uncertainties.

Read the ruling: https://public-inspection.federalregister.gov/2023-24184.pdf

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