Is the 16-Day RPM Rule No Longer a Revenue Barrier for OBGYNs?

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The 16-day RPM rule is becoming less of a revenue barrier for OBGYNs due to regulatory clarifications, improved device compliance, and better billing workflows. Previously, the requirement that remote patient monitoring (RPM) devices collect data for at least 16 days per 30-day period limited reimbursement opportunities. For OBGYN practices managing pregnancy-related monitoring and chronic maternal conditions, this rule often restricted consistent RPM reimbursement . Recent operational adjustments and clearer CMS guidance are changing how practices approach RPM billing for OBGYNs . What Is the 16-Day RPM Rule? The 16-day RPM rule requires that patient monitoring devices record and transmit data for at least 16 days within 30 days to qualify for monthly RPM reimbursement. This rule was designed to ensure consistent patient engagement, but it created challenges in: Short-term pregnancy monitoring Intermittent blood pressure tracking Gestational diabetes management Post...
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Impact of 2023 MPFS Proposed Rule on Neurology Billing

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2023 Medicare Physician Fee Schedule Proposed Rule

Recently, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 revisions to payment policies under the Medicare Physician Fee Schedule (MPFS) and other changes to the Medicare part B payment policies (CMS-1770-P) proposed rule. In this article, we shared the impact of the 2023 MPFS proposed rule on neurology billing, the key points are as follows:

Impact of 2023 MPFS Proposed Rule on Neurology Billing

  • CMS shows the impact of the provisions of the rule to be a zero percent chance for neurosurgery. However, CMS proposes a CY 2023 conversion factor (CF) of 33.0775, which is a 4.42 percent (rounded to 4.5%) reduction relative to the CY 2022 CF of 34.6062, which comes in addition to the pending 4% pay-as-you-go cut that congress postponed last year and the resumption of the 2% annual Medicare payment sequester.
  • CMS received a request to designate CPT code 23091 (Allograft, structural, for spine surgery only) as potentially misvalued. CMS has disagreed with the rationale provided by the requester and is proposing not to designate the procedure as misvalued.
  • CMS is considering proposals to rebase and revise the Medicare Economic Index (MEI) cost share weights, and the agency is soliciting comments on this issue. The MEI measures the input prices for providing physician services. The agency proposes a new methodology allowing data to reflect better current market conditions for both physician ownership practices and self-employed physicians. It will also enable the MEI to be updated more frequently. The change would not impact the overall MPFS spending but could result in significant changes to payment for particular specialties. CMS is not proposing to use the updated MEI data to set payment rates for CY 2023 but is soliciting comments on future use.

To know more about the Impact of the 2023 MPFS Proposed Rule on Neurology Billing click here: http://bit.ly/3Zuoyn9 Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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