Policy Analysis, Coding and Reimbursement Resources
New Physician Specialty Code for Epileptologists
We are pleased to announce the implementation of a new physician specialty code, F6, used to indicate the specialty designation for an epileptologist. The new code, created by the Centers for Medicare & Medicaid (CMS) is the result of a collaborative effort among specialty societies that included submitting a [...]
New Guidelines for Centers
NAEC is thrilled to announce the publication of its 2023 Guidelines for epilepsy centers! An Executive Summary of the 2023 Guidelines for Specialized Epilepsy Centers: Report of the National Association of Epilepsy Centers Guideline Panel was published online on February 2, 2024, in Neurology®, the medical journal of the American Academy of Neurology. The complete [...]
CMS Approves New Subspecialty Code for Epileptologists
As a result of a collaborative request from the American Epilepsy Society (AES), the American Clinical Neurophysiology Society (ACNS), and the National Association of Epilepsy Centers (NAEC), the Centers for Medicare & Medicaid (CMS) has approved a new specialty code for epileptologists. The new code will allow CMS to [...]
CMS Releases Medicare Proposed Regulations for 2024
The Centers for Medicare and Medicaid Services (CMS) released proposed rules for 2024 on the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (HOPPS). Both rules are open for comments until mid-September and the final rules are typically released in November. Changes in policy and payment [...]
NAEC Resources on Long-Term EEG Monitoring
Beginning on January 1, 2020, the CPT coding structure for long-term EEG and EEG with video monitoring (VEEG) changed dramatically. NAEC has been working with AAN, ACNS, and AES to provide summaries of the coding changes, webinars, and an analysis of the Medicare Physician Fee Schedule’s treatment of the [...]
CMS Releases Medicare Proposed Regulations for 2023
This month, the Centers for Medicare and Medicaid Services released proposed rules for 2023 on the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (HOPPS). Both rules are open for comments until mid-September and the final rules are typically released in November. Changes in policy [...]
Calendar Year 2022 Medicare Physician Fee Schedule Proposed Rule Released
On July 13, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2022 Medicare Physician Fee Schedule (MPFS) for services effective January 1, 2022. A summary of the major provisions of the MPFS proposed rule impacting epilepsy centers, including charts showing physician work relative value units [...]
HHS Extends Public Health Emergency through April and Medicare Conversion Factor Increased by Congress
On Monday, January 11, the Secretary of Health and Human Services extended the COVID-19 Public Health Emergency declaration for an additional 90 days. This will extend the telehealth and other flexibilities and waivers under Medicare and Medicaid until April 21, 2021. In addition, CMS has recalculated the Medicare Physician [...]
Congress Mitigates 2021 Reduction in Medicare Payments for Physician Services
Yesterday, Congress passed a comprehensive year-end bill that funds the federal government through FY 2021 and provides a new round of COVID relief and economic stimulus funds. The bill also included changes to the 2021 Medicare Physician Fee Schedule, including two provisions which will mitigate the 10.2% reduction in Medicare’s [...]
Medicare Physician Fee Schedule for CY 2021 Proposed Rule Released
Medicare Physician Fee Schedule for CY 2021 Proposed Rule Released A summary of the major provisions of the CMS proposed rule impacting epilepsy centers along with charts showing the relative value units and Medicare national average payment rates for neurology, neurosurgery, and evaluation and management services can be found here. [...]
CMS Releases Rules Providing Flexibility to Providers during the COVID Emergency
On March 30, 2020 and April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued Interim Final Rules providing significant flexibility in Medicare coverage and payment for hospital and physician services and waivers on other Medicare and Medicaid requirements. Most of these changes were made effective as [...]
COVID-19 Resources for NAEC Members
NAEC July 2020 COVID Survey Results CMS Encourages Reopening of Healthcare Facilities On June 9, 2020, the Centers for Medicare and Medicaid Services (CMS) released additional guidance on reopening healthcare facilities. Centers for Medicare & Medicaid Services (CMS) Recommendations: Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare Patient Guide in English [...]
CMS Announces Change in Medicare Telehealth Benefits & HIPAA Policy during COVID-19 Outbreak
Expanded Telehealth Benefits On March 17, the Centers for Medicare and Medicaid Services (CMS) expanded telehealth benefits for Medicare beneficiaries during the COVID-19 outbreak to allow individuals to receive a wider range of healthcare services without having to travel to a healthcare facility. Clinicians can bill immediately for dates [...]
New Long Term EEG/VEEG CPT Codes – 95700-95726
New Long Term EEG/VEEG CPT Codes – 95700-95726 Beginning on January 1, 2020, the CPT coding structure for long-term EEG and EEG with video monitoring (VEEG) changed dramatically. NAEC has been working with AAN, ACNS, and AES to provide summaries of the coding changes, webinars, and an analysis of the [...]
NAEC/AES Session on New Long Term EEG Codes
NAEC/AES Session on New Long Term EEG Codes NAEC and AES Members were eager to learn the details of the new long-term EEG coding structure for 2020 at the Coding Session sponsored by both organizations during the AES Conference in Baltimore, MD. The information presented by Drs. Nathan Fountain, Gregory [...]
NAEC Summaries of Medicare Final Rules for 2020
CMS released its final rules for the 2020 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) in early November. NAEC has prepared summaries of the provisions of the rules that are of greatest impact to its members with charts showing relative value units and national average [...]
2020 Medicare Physician Fee Schedule Proposed Rule Summary and Charts
NAEC annually provides its members with a detailed summary of the Medicare Physician Fee Schedule (MPFS) Proposed Rule, along with charts showing the relative value units and payment rates. This year we did two summaries to provide additional details on the new EEG codes. MPFS Proposed Rule: Most noteworthy for [...]
Medicare Final Rule on Medicare Advantage and Part D Drug Pricing
Protected Class Policy for AEDs Maintained in Medicare Part D Final Rule On May 16, 2019 the Centers for Medicare and Medicaid Services (CMS) published its final rule on Medicare Advantage and Part D Drug Pricing. The final rule did not move forward on CMS’ proposals made earlier this year [...]
CODING UPDATE
NAEC recently received requests for more information on the new long term EEG codes that will take effect on January 1, 2020. The new codes will not be publicly released until July 2019. NAEC, in collaboration with AAN, AES, and ACNS will distribute more information and hold several webinars later [...]
2019 Medicare Final Rules on Physician Fee Schedule and Hospital Outpatient Payment System Released
In early November, CMS released the final regulations for the CY 2019 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS). NAEC has prepared summaries of the rules and charts showing payment for epilepsy center services, which can be found here: NAEC 2019 Final MPFS Summary [...]
CMS Finalizes 2019 Medicare Rules
Medicare 2019 Final Rules on Physician Fee Schedule and Hospital Outpatient Payment System Released In early November, CMS released the final regulations for the CY 2019 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS). NAEC has prepared summaries of the rules and charts showing payment for [...]
MS Releases Proposed Rule on Hospital Outpatient Prospective Payment System for 2019
NAEC has prepared a brief summary of the Medicare Hospital Outpatient Prospective Payment System (HOPPS) proposed rule for 2019. In general, the rule provides for a 1.25% update in hospital outpatient payment rates in 2019. Hospitals that fail to meet the hospital outpatient quality reporting requirements will receive a 2% reduction [...]
AMA Releases Long Term EEG Coding Changes from May 2018 CPT Panel Meeting
In July, the AMA published a summary of the May 2018 CPT Editorial Panel Meeting. At this meeting the Panel approved changes to the Long Term EEG Monitoring Codes, which have been under discussion for over a year. These changes will not take effect until January 1, 2020. Physicians should [...]
Medicare Final Regulations for CY 2018 Released
The Centers for Medicare and Medicaid Services has released the CY 2018 Final Rules on the Medicare Physician Fee Schedule and the Hospital Outpatient Prospective Payment System. In general, payment for epilepsy center services under Medicare will remain stable in 2018. NAEC has prepared a summary of the major provisions [...]
CMS Releases 2016 Final Rule on the Hospital Outpatient Prospective Payment System
On October 30, 2015, the Centers for Medicare and Medicaid Services (CMS) released its final regulations setting payment rates for physician and hospital outpatient services for 2016. The Hospital Outpatient Final Rule chart shows the Medicare hospital outpatient payment rates for 2016 for epilepsy center services. CMS finalized its proposal [...]
CMS Releases 2016 Final Rule on Medicare Physician Fee Schedule
On October 30, 2015, the Centers for Medicare and Medicaid Services (CMS) released the Final Medicare Physician Fee Schedule (MPFS) for 2016. The final rule updates payment policies and payment rates for services furnished under the MPFS and includes changes to the quality reporting initiatives associated with the MPFS – [...]
Medicare Physician Fee Schedule Archives (2008-2015)
The Medicare Physician Fee Schedule (MPFS) Final Rule provides payment rates and policies for physician services and other practitioner services as well as updates to Medicare’s quality reporting programs. NAEC provides an analysis of each rule and prepares charts with payment rates for epilepsy center services for its members. [...]
