By Anna Horner | News & Views
The Centers for Medicare & Medicaid Services (CMS) makes changes to Medicare rules and regulations on an annual basis, and it is important for cardiac rehabilitation (CR) and pulmonary rehabilitation (PR) providers to keep abreast of these changes to ensure they bill appropriately for their services. Although it can be hard to keep track of the changes year to year, doing so is crucial to avoid audits and payment denials.
In an AACVPR webinar that streamed live on December 7 and was recorded for future viewing, Lorri Lee, MHA, BS, CCRP, CEP, FAACVPR, and Susan Flack, MS, BSN, RN, FAACVPR, explain current Medicare billing and coding processes, changes to these processes for 2024, legislation slated to go into effect in January and legislative priorities for the new year. “If you understand how regulations come down from law to CMS to interpretations by other providers, it's important for you to understand that not all rules apply to every patient,” Lee says. According to Lee and Flack, the one-hour session touches on the basic regulations governing the reimbursement and practice of CR, PR, Supervised Exercise Therapy for Peripheral Artery Disease (SET PAD), and Outpatient Respiratory Services (ORS).
The webinar also addresses "some of the changes to the supervision of cardiac, intensive cardiac and pulmonary rehab moving into 2024, specifically the fulfillment of legislation that's taking place in January 2024,” Lee says. She and Flack explain the new regulations CMS has proposed for 2024 as well as new pay rates, reimbursement in all program Current Procedural Terminology (CPT) codes, changes in virtual and direct supervision, and how the roles of certain non-physician providers will change in the new year. Practical, real-world examples for the implementation of the proposed changes by Medicare for CR and PR are provided as well.
Among other points, Lee and Flack address ongoing confusion regarding covered diagnoses, appropriate use of International Classification of Diseases, Tenth Revision (ICD-10) codes and proper billing procedures. “There are misconceptions about the supervision roles that will take effect in January,” Flack says, but the webinar clarifies "what is and isn’t changing because some of the rumors out there are inaccurate.”
Both experienced and novice leaders and clinicians in CR and PR can benefit from an overview of the legislation and regulatory structure and changes that will go into effect January 1 as well as AACVPR’s legislative priorities for the coming year.
The livestream event has ended. For information on the webinar recording of "2024 Medicare Rules & Regulations" presented by Lorri Lee, MHA, BS, CCRP, CEP, FAACVPR, and Susan Flack, MS, BSN, RN, FAACVPR, click here.