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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MPFS Strengthening Behavioral Health Billing for 2023

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CY 2023 Medicare Physician Fee Schedule (MPFS)

The Centers for Medicare and Medicaid Services (CMS) on Nov. 1, 2022, released the final 2023 Medicare Physician Fee Schedule (MPFS), addressing Medicare payment and quality provisions in the coming year. The U.S. Department of Health and Human Services (HHS) through its Centers for Medicare & Medicaid Services (CMS) is expanding access to behavioral health care. The Calendar Year 2023 Physician Fee Schedule (PFS) final rule announced today also promotes innovation and coordinated care in the Medicare program through Accountable Care Organizations (ACOs). This rule directly supports the Administration’s commitment to strengthening behavioral health, which the President outlined in his first State of the Union Address, and the comprehensive strategy to tackle the nation’s mental health crisis. In this article, we shared key behavioral health billing updates from CY 2023 MPFS which would act as a baseline for your behavioral health billing for 2023.

MPFS Strengthening Behavioral Health Billing for 2023

In light of the current needs among Medicare beneficiaries for improved access to behavioral health services, CMS has considered regulatory revisions that may help to reduce existing barriers and make greater use of the services of behavioral health professionals, such as licensed professional counselors (LPCs) and Licensed Marriage and Family Therapists (LMFTs). Therefore, CMS is finalizing the proposal to add an exception to the direct supervision requirement under our ‘incident to’ regulation at 42 CFR 410.26 to allow behavioral health services to be provided under the general supervision of a physician or non-physician practitioner (NPP), rather than under direct supervision, when these services or supplies are furnished by auxiliary personnel, such as LPCs and LMFTs, incident to the services of a physician (or NPP).

To know more about MPFS Strengthening Behavioral Health Billing for 2023 click here: http://bit.ly/3EpZTry Contact us at info@medicalbillersandcoders.com/ 888-357-3226.


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