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CMS Releases 2017 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) on Nov. 2 released the calendar year (CY) 2017 physician fee schedule (PFS) final rule, which includes Medicare Shared Savings Program (MSSP) changes and telehealth provisions of particular interest to members of America’s Essential Hospitals.

MSSP Changes

The PFS final rule, which updates payment policies and rates for services furnished on or after Jan. 1, includes final policies specific to certain sections of the MSSP regulations, such as:

  • updates to accountable care organization (ACO) quality reporting requirements, including changes to the quality measure set to align with the Core Quality Measures Collaborative and the newly finalized Quality Payment Program (QPP);
  • revisions to permit eligible professionals in ACOs to report quality separately from the ACO;
  • updates to align with the Physician Quality Reporting System and the final QPP; and
  • modifications to how beneficiaries are assigned to an ACO based on a beneficiary’s designation of an ACO professional as responsible for their overall care.

Telehealth Provisions

Additionally, CMS finalized the addition of codes to the list of services eligible to be furnished via telehealth, including:

  • end-stage renal disease—related services for dialysis;
  • advance care planning services; and
  • critical care consultations furnished via telehealth using new Medicare G-codes.

Further, the agency finalized payment policies for use of a new place of service code specifically designed to report services furnished via telehealth.

The PFS rule also finalized implementation of the Medicare Diabetes Prevention Program (MDPP) expanded model, beginning Jan. 1, 2018. The MDPP expanded model is a behavioral change intervention that aims to prevent the onset of type 2 diabetes among Medicare beneficiaries diagnosed with pre-diabetes, through improved access to community-based interventions.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Maryellen Guinan is a senior policy analyst at America's Essential Hospitals.

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