Comments Due September 9 for New CMS Proposed Rule

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS), issued the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS) proposed rule. Among several components, the proposed rule includes measures intended to strengthen primary care; expand access to behavioral health, oral health, and caregiver training services; maintain telehealth flexibilities; and expand access to screening for colorectal cancer and vaccinations for hepatitis B. The Department of Health and Human Services (HHS) says that the policies proposed would advance health equity and support whole-person care. See a general overview of the proposed updates from the American Osteopathic Association’s public policy team.  

The proposed rule includes several policy changes related to behavioral health integration and that are intended to expand behavioral health access. These include changes to support the delivery of advanced primary care and promote access to preventive services. The proposed rule establishes new codes for Advanced Primary Care Management (APCM) designed to capture the broad range of services that comprise advanced primary care and the designation of new services as preventive under the fee schedule. CMS is acting on findings from value-based primary care models tested by their Innovation Center that comprehensive primary care can better meet patient needs while also reducing emergency department and hospital visits. The proposed rule also calls for reimbursement for digital mental health treatment and the extension of existing virtual care payment rules.

The 60-day comment period for the CY 2025 PFS proposed rule (CMS-1807-P) ends September 9, 2024. Use 1 of the 3 following ways to officially submit your comments:

• Electronically: www.regulations.gov 
• Regular mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1807-P, P.O. Box 8016, Baltimore, MD 21244-8016.
• Express or overnight mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1807-P, Mail Stop C4- 26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850.

See the CMS-1807-P Federal Regulation Notice for the full proposed rule.

AHRQ Academy resources that relate to these topics include topic briefs on Health Equity, Behavioral Health Apps, and Telehealth.