New Medicare billing rights for physician assistants
Beginning Jan. 1, 2022, physician assistants (PAs) will be able to bill Medicare independently for their services. These changes, announced in the 2022 proposed Medicare physician fee schedule rule, implement a law enacted by Congress in early 2021 that gives PAs the same Medicare billing rights as nurse practitioners. Currently, PA services must be billed by the PA’s physician employer. There is no change, however, in Medicare supervision requirements; PA services must still be performed under physician supervision. Therefore, while PAs may be able to establish themselves in independent practice (if their state allows), Medicare would still require that they be supervised by a physician.
Medicare to cover remote therapeutic monitoring
The Centers for Medicare and Medicaid Services is proposing to cover five new remote therapeutic monitoring (RTM) codes, including one specifically focused on remote monitoring of the respiratory system. These new codes, which are similar to the existing remote physiological monitoring codes (CPT Codes 99453-99458), would take effect on Jan. 1, 2022. The codes, which can be billed monthly, could be used by allergists who are providing patients with home monitoring devices for respiratory status and who are managing their treatment remotely.
CMS is proposing to reimburse approximately $45 every 30 days for provision of the device used to monitor respiratory status. The treatment management service requires at least one interactive communication per month with the patient and at least 20 minutes of physician or clinical staff time managing the patient’s care. Payment for treatment management service is approximately $51 per month. Furthermore, an add-on code is available for each additional 20 minutes and is reimbursed at approximately $41.
