On October 5, ASAM submitted comments on the proposed 2021 Medicare Physician Fee Schedule (MPFS). The proposal includes many important sections, including changes to telehealth services offered through Medicare, and expanding the range of eligible disorders for the billing of certain bundled payments. The proposal also includes the establishment of a new code to be billed with E/M visit codes used in the ED setting to pay for assessment, referral to ongoing care, follow-up after treatment begins, and arranging access to supportive services. Finally, the proposal would create two new codes to reimburse opioid treatment programs for providing naloxone to their patients, change electronic prescribing requirements, and establish new codes to bill for specific buprenorphine products.

ASAM’s comments stressed the importance of the Centers for Medicare and Medicaid Services altering the MPFS to expand access to treatment for as many beneficiaries suffering from substance use disorder (SUD) as possible. Specifically, by introducing new codes for telehealth, expanding the range of eligible disorders for the billing of certain bundled payments, and empowering ED clinicians through the creation of a new code, CMS has taken great strides towards ensuring that all Medicare beneficiaries can access evidence-based treatment for their SUD.

Read ASAM’s comments here.

Read the 2021 proposed Medicare Physician Fee Schedule here.

Read a summary of the proposed 2021 Medicare Physician Fee Schedule here.