Guide

The CY 2021 Medicare Physician Fee Schedule Final Rule was placed on display at the Federal Register on December 2, 2020. This final rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2021. This final rule updates policies affecting the calculation of payment rates and includes misvalued codes. It also adds services to the telehealth list including a third temporary category for services added under the PHE, as well as certain other revisions to telehealth services.

These clinical tools include guidance and forms for the implementation of medication-assisted treatment in ambulatory care settings.

Starting January 1, 2020, under the Calendar Year (CY) 2020 Physician Fee Schedule final rule the Centers for Medicare & Medicaid Services will pay Opioid Treatment Programs through bundled payments for opioid use disorder treatment services in an episode of care provided to people with Medicare Part B (Medical Insurance).

In the Calender Year 2020 Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services included new coding and payment for a monthly bundle of services for the treatment of opioid use disorder that includes overall management, care coordination, individual and group psychotherapy, substance use counseling, and add-on code for additional counseling. This is a way for clinicians to bill for a group of services in the office setting similar to the services covered under the Opioid Treatment Program benefit for clinics.

Assists clinicians and administrators in implementing behavioral healthcare using telehealth by offering key considerations and examples of using telehealth for behavioral health

Outlines steps and best practices when implementing telehealth strategies to promote adoption of new technology by healthcare organizations

Guides behavioral health providers through using telehealth with their patients, particularly during the COVID-19 pandemic

Provides guidance to clinicians and practices on using telehealth for substance use services during COVID-19, including benefits of using telehealth, Federal and State policy changes, private payers, and general considerations

Explains topics related to billing Medicare and Medicaid for telehealth services, such as billing codes, policies, and application during COVID-19

This tool outlines a framework for implementing adolescent SBIRT within primary care. The framework includes operational guidance for adopting strategies to create optimal conditions for change, as well as clinical areas for action for SBIRT implementation.