Learn which proposals to the Medicare Part B Physician Fee Schedule (PFS) have been finalized and adopted by CMS. Statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 PHE will retake effect for most telehealth services in 2025. The CY 2025 final rule reflects CMS' goal to preserve some flexibility to expand the scope of and access to telehealth services. Learn the details that will help you best determine what course of action your practice should take in response. Make informed decisions to guide your practice in a positive direction.
Key provisions that have been finalized:
- 2.83% decrease to the conversion factor
- Additions to the Medicare Telehealth Services List
- Expanded definition of interactive telecommunications system
- New coding and payment for caregiver training services
- New G-codes for Advanced Primary Care Management Services for beneficiaries with chronic conditions
- Expanded usability of add-on code G2211
- Coding and payment for an ASCVD risk assessment service and risk management services
- G-code for safety planning interventions by Behavioral Health billing practitioners
- Medicare payment for digital mental health treatment devices
- Expanded coverage for Hepatitis B vaccines and colorectal cancer screening
- Cap on out-of-pocket drug costs and new payment options for beneficiaries
- Broadened applicability of the transfer of care modifier for global packages
- Relaxed direct supervision requirements for certain providers/services
- 6 new MIPS Value Pathways (MVPs)
- Consolidation of 2 neurology-focused MVPs into a single neurological MVP
- Expanded definition of primary care services under MSSP
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Jan Hailey
MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M
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Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.
Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.
Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.
Advanced knowledge of the latest healthcare compliance and Medicare changes will prepare medical practice leaders and their teams to forecast the impact of annual updates and industry changes and respond proactively.
This is an intermediate-level course designed for medical practice leaders and their teams responsible for managing the business aspects of a healthcare practice. A basic level of knowledge of provider billing and compliance processes is assumed.
Self-paced online program includes unlimited review of previously recorded instruction and downloadable digital companion materials for 6 months.
Comments from past participants:
"It was very informative and very well put together."
"Course and instructor were excellent!
"Presenter is well informed and very easy to follow."
Prod ID: 496