December 17, 2024

NEED TO KNOW

Medicare Billing & Coding Changes for 2025 – New Primary Care Codes, Potential Telehealth Losses

As a reminder, included in the 2025 Medicare Physician Fee Schedule final rule are new codes and changes related to billing for services.   CMS’s detailed summary of changes contained in the Fee Schedule is available here; the AMA has a summary of the rule here; and a short summary highlighting the top four changes physicians should be aware of is also available from AAFP.   Included on the top changes to note are:

• New payments for Advanced Primary Care Management (APCM) services – which offer between $15-110 and can be billed monthly.  These are described by three new HCPCS G-codes (G0556, G0557, G0558) and incorporate elements of several existing care management and communication technology-based services into a bundle of services that reflects the essential elements of the delivery of advanced primary care.   Read more here.
• Absent action from Congress before the end of the year, many telehealth restrictions from Medicare will go back into place.  These include geographic and location restrictions on where the services are provided, and limitations on the scope of practitioners who can provide Medicare telehealth services.  Many advocates are pushing Congress to extend these flexibilities.
• Medicare payments for professional services will decrease for the fifth year in a row, by approximately 2.83%.  The AMA, VMS and state medical societies continue to urge Congress to take action to avert the cut before the end of the year. 

For more information, contact Jessa Barnard at jbarnard@vtmd.org.

Legislative Breakfasts Just Around the Corner – Intro Advocacy Webinar January 9th

Your voice makes a difference! Please join us in 2025 to meet your lawmakers over coffee and a light breakfast. These breakfasts, which will be held in the cafeteria at the Vermont Statehouse in Montpelier are an informal opportunity to educate lawmakers on ways to improve Vermont's practice environment and health care system.  You don’t need any prior advocacy experience to join! Each breakfast starts on specific Wednesday at 8-9:30AM.  The first all specialty/VMS breakfast kicks off on January 15^th.  Register here. 

We will also be hosting an Intro to Advocacy and legislative breakfast logistics webinar Thursday, January 9^th from 7:30-8am.  The webinar will also be recorded for those who can’t join live. Join the Zoom link on the 9th here.

The dates for the breakfasts are:

VMS/All Specialties – January 15

Family Physicians – February 19

Pediatrics – March 19

Vermont Ophthalmological Society – March 26

Family Physicians – April 2

VMS/All Specialties - April 16

Family Physicians – April 30

Please reach out to Jill Sudhoff-Guerin at jsudhoffguerin@vtmd.org if you have any questions and be sure to register to receive important logistics and policy updates before your breakfast.

MISC.

Medicaid Clinical Utilization Review Board Recruiting Qualified Physician Board Members

Vermont Medicaid’s Clinical Utilization Review Board (CURB) is recruiting physician Board members. The CURB's function is to examine existing medical services and clinical practice guidelines and make recommendations to DVHA regarding services in the state’s Medicaid program. The Board is comprised of 10 members with diverse medical experience. Meetings are held primarily remotely every other month for a total of 6 meetings per year. Members receive per diem compensation and mileage reimbursement when applicable. More information including agendas and minutes can be found at https://dvha.vermont.gov/advisory-boards/clinical-utilization-review-board.

For additional information on becoming a member of the CURB, please email AHS.DVHAClinicalServicesTeam@vermont.gov.

Next Commissioner Call, January 2, 2024

The Commissioner of Health, Mark Levine, MD, will hold his next Public Health Update with VMS Members this Thursday, January 2nd at 12:30 pm. You can join the zoom meetings here.

He held his most recent VMS member call on December 5th. Notes from the call are here.

Give yourself the gift of more compensation in 2025

Get your compensation analyzed instantly to see where you stack up against both MGMA's most recent survey as well as your colleagues contract offers with Resolve's instant compensation review. You'll also get a free risk report that identifies problematic contract terms and explains how and why they should be negotiated.

Vermont Medical Society members receive a special holiday discount of $100 off through Dec 31 with code VMSHolidayComp when you visit this link.

Here's to fair compensation for physicians in 2025!

AMA STEPS Forward: The Best of 2024 - Top Resources for a Healthier Practice

As 2024 comes to a close, the AMA STEPS Forward® team is celebrating the most popular resources that helped redesign physician practices and reignite your purpose.

From practical strategies to actionable insights, our Innovation Academy webinars have helped physicians and health care leaders improve professional satisfaction and streamline their practice. Explore the top three webinars of 2024, all available now on demand:

• Navigating AI in Health Care
• Reducing Regulatory Burden in Health Care
• Plan, Do, Study, Act

Our toolkits offer hands-on solutions for tackling key challenges in health care. Designed to save time and boost well-being, these resources empower you to streamline workflows and enhance the patient experience. Check out the top three toolkits of 2024:

• “Real PTO” for Physicians
• Pre-Visit Planning
• Simplified Outpatient Documentation and Coding

Dive into inspiring conversations with health care leaders who share real-world approaches to combat burnout, improve patient care, and put the joy back into medicine. Here are the top three episodes of 2024 you won’t want to miss:

• Write Shorter Notes: Implementing a Standardized Progress Note Template
• GROSS: Get Rid of Stupid Stuff!
• Reduce Burnout, Improve Self-Compassion With Group Coaching for Even the Busiest Physician

This year’s top resources covered essential topics to help health care teams navigate complex issues and overcome obstacles so they can focus on what matters most – patient care. Discover the top three resources of 2024 that helped practices make a difference:

• Wellness-Centered Leadership Playbook
• Debunking Regulatory Myths: Can Physicians Bill for Both Preventive and E/M Services in the Same Visit?
• AMA Telehealth Quick Guide on Policy, Coding and Payment

Explore more content, stay in touch and follow us on LinkedIn.  Questions? Email stepsforward@ama-assn.org.

EVENTS

Contemporary Issues in Health Care Ethics: A 4 Part Series

January 2025, 12pm - 1:15pm

AI in Healthcare: Legal and Ethical Challenges

January 9th - Register here.

How Health Care Can Outgrow Bias

January 14th - Register here

Critical Issues in the Care of Older Adults with Cognitive Impairment

January 21st - Register here

Incapacitated Refusals & Vermont's Ulysses Clause

January 30th - Register here

42nd PAAV Annual Winter CME Conference

January 30th - February 2nd, 2025

The annual winter PA Academy of Vermont Conference is at Stoweflake in Stowe, VT 1/30/25 -2/2/25

Please come join the fun and get CME too!

VMS President, Dr. Katie Marvin speaking on Saturday!

The early bird rate is extended through 12/13/24. (save $100)

Learn more and register here.

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

October 2024 – March 2025

AMA STEPS Forward^® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

For more information about offerings from UVM CMIE, visit here.

Vermont Medical Society

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Montpelier, VT 05602

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