CMS final rule focuses on improved care coordination

CMS has finalized payment rates and policies for 2014, including a proposal to support care management outside routine office interactions, the agency announced last week. The final rule sets payment rates for physicians and non-physician practitioners paid under the Medicare Physician Fee Schedule for 2014, and addresses policies included in the proposed rule issued in July. The 2014 payment rates increase payments for many specialties. Some of the greatest increases will go to providers of mental health services including psychiatrists, clinical psychologists, and clinical social workers.

As part of CMS’ effort to recognize the critical role primary care plays in providing care to beneficiaries with multiple chronic conditions, beginning in 2015, the agency is establishing separate payments for managing a patient’s care outside of a face-to-face visit for practices equipped to provide these services, CMS stated.

Separately, CMS released a final calendar year 2014 hospital outpatient and ambulatory surgical center (ASC) payment rule—CMS-1601-FC—that will give hospitals and ASCs new flexibility to lower outpatient facility costs and strengthen the long-term financial stability of Medicare. In addition, CMS will replace the current five levels of hospital clinic visit codes for both new and established patients with a single code describing all outpatient clinic visits. A single code and payment for clinic visits simplifies administration for hospitals and better reflects hospital resources involved in supporting outpatient visits.