CMS Proposed Rule for 2023

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About Course

Every summer CMS publishes its proposed new physician payment and coding change guidelines for the coming year. The proposed rule gives providers a chance to make positive or negative comments on their proposed changes. In some cases, provider comments can influence CMS to deviate from their original proposed guidelines. It is very important for providers and staff to know what is proposed in order to provide CMS with quality feedback. This year there are significant changes to EM services that will require a complete change in the way services are coded outside of the office setting.

Learning Objective

  • Correct coding of EM services outside of the office setting
  • Will CMS’s new conversion factor for 2023 affect your bottom line?
  • Changes to colorectal cancer screening guidelines
  • How shared care will change or not change for 2023?
  • Identify new telehealth services available after the end of PHE
  • Review the role of clinical psychologists, clinical social workers, professional licensed counselors, and licensed marriage and family therapists in improvements to access to behavioral health services
  • New codes and strategies for chronic pain management
  • Understand new payment methodology and codes for Methadone treatment drugs
  • Review proposed guidelines for patient access to audiology services and dental oral health care.
  • Understand new payment and classification of wound care management products.

Areas Covered in the Session:

  • The new conversion factor for 2023
  • EM Codes outside of the office setting
  • Shared care
  • Colorectal screening guidelines
  • Proposed updated telehealth availability
  • Chronic care management
  • 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

Suggested Attendees

  • Surgeons
  • Coding Personnel
  • Denial Management team
  • Office Managers
  • Insurance Payers
  • Physicians
  • Physical Assistant
  • Billers
  • Coders
  • Medical Assistants
  • Claims Adjuster
  • Claims Processor
  • Auditor
  • NP, APN, CNS
  • Executive and Administration
  • Compliance Officers
  • Charge Capture
  • Appeals
  • Medical Records Staff
  • A/R Staff

About the Presenter:

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 35 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992 with active membership in the American Academy of Procedural Coders (AAPC). As a member of the AAPC, Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributing to the development of AAPC’s independent study and university education programs and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year.  Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination Committee.

In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.

In previous consulting positions she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/Gyn, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.

Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37 provider, staff model HMO clinic. As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.

Course Content

You can access all the webinar materials after successful payment

  • Webinar Link + Handouts PDF
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