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There is often excitement and anticipation about CMS’s Proposed Physician Rule, due to be released at the end of June. The rule can be boring (wage index changes for practice expense) and exciting (E/M policy changes). This year, we will be looking at CMS’s values for the revised E/M services, which they told us about at the end of 2020. And, even more important, what will the conversion factor be, and how will the E/M changes and conversion factor update change revenue, by specialty. CMS also includes a section on telehealth each year, and while CMS has not committed to keeping the new telehealth rules, they will certainly discuss telehealth in the proposed rule.

This webinar will provide a high-level overview of the policy changes that CMS discusses in their 2021 proposed rule.

At the end of the session, participants will be able to:

• Describe the timeline for comments and the final rule
• List policy changes proposed for 2021
• Define the timeline for changes to new and established patient visits codes

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Physicians are frustrated when they do work, not related to seeing a patient, and don’t get paid for it. And yet, it is vitally important to their patients and families.

This webinar will describe three sets of care management services that can be billed by primary care practitioners and specialists. Transitional care management (TCM) is for managing the transition of complex patients from a facility to a non-facility (typically, home). Principal care management (PCM) services, currently described with HCPCS codes, were developed for specialists managing one serious condition. And chronic care management (CCM), describes work that can be performed by clinical staff or practitioners for patients with two or more chronic illnesses. This webinar will describe the rules and reimbursement for TCM, PCM and CCM.

After the webinar, participants will be able to:

• Select the correct care management service
• Describe the time requirements for services their practice can perform, and whether the service must be done by the billing practitioner or clinical staff
• Review the documentation for the service

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While both CPT allows medical practices to bill for both a preventive service and an E/M. CMS allows practices to bill for both a wellness visit and an E/M.  When to do it, and how to document the distinct and separate work of the E/M service, isn’t very clear. This webinar will provide an overview of what is included in preventive services and Medicare wellness visits, and when a problem-oriented visit can be reported in addition. It will provide a framework for practices when determining when there is significant extra work performed and documented, supporting the addition of a problem-oriented visit.

After the webinar, participants will be able to:

• List what is included in preventive and wellness visits
• Implement a framework to determine if a separate E/M service should be reported
• Suggest communication messages to patients within their practices