MPFS Strengthening Behavioral Health Billing for 2023

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MPFS Strengthening Behavioral Health Billing for
2023
CY 2023 Medicare Physician Fee Schedule
(MPFS) The Centers for Medicare and Medicaid
Services (CMS) on Nov. 1, 2022, released the
final 2023 Medicare Physician Fee Schedule
(MPFS), addressing Medicare payment and quality
provisions in the coming year. The U.S.
Department of Health and Human Services (HHS)
through its Centers for Medicare Medicaid
Services (CMS) is expanding access to behavioral
health care. The Calendar Year 2023 Physician Fee
Schedule (PFS) final rule announced today also
promotes innovation and coordinated care in the
Medicare program through Accountable Care
Organizations (ACOs). This rule directly supports
the Administrations commitment of strengthening
behavioral health, which the President outlined
in his first State of the Union Address, and the
comprehensive strategy to tackle the nations
mental health crisis. In this article, we shared
key behavioral health billing updates from CY
2023 MPFS which would act as a baseline for your
behavioral health billing for 2023. MPFS
Strengthening Behavioral Health Billing for
2023 In light of the current needs among
Medicare beneficiaries for improved access to
behavioral health services,
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MPFS Strengthening Behavioral Health Billing for
2023
CMS has considered regulatory revisions that may
help to reduce existing barriers and make greater
use of the services of behavioral health
professionals, such as licensed professional
counselors (LPCs) and Licensed Marriage and
Family Therapists (LMFTs). Therefore, CMS is
finalizing the proposal to add an exception to
the direct supervision requirement under our
incident to regulation at 42 CFR 410.26 to
allow behavioral health services to be provided
under the general supervision of a physician or
non-physician practitioner (NPP), rather than
under direct supervision, when these services or
supplies are furnished by auxiliary personnel,
such as LPCs and LMFTs, incident to the services
of a physician (or NPP). CMS is also clarifying
that any service furnished primarily for the
diagnosis and treatment of a mental health or
substance use disorder can be furnished by
auxiliary personnel under the general supervision
of a physician or NPP who is authorized to
furnish and bill for services provided incident
to their own professional services. CMS believes
that this change will facilitate access and
extend the reach of behavioral health services.
Finally, CMS indicated in the final rule that we
intend to address payment for new codes that
describe caregiver behavioral management training
in CY 2024 rulemaking. Coverage for Opioid Use
Disorder Treatment
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MPFS Strengthening Behavioral Health Billing for
2023
In the 2022 CMS Behavioral Health Strategy, CMS
included a goal to improve access to, and quality
of, mental health care services and included an
objective to increase detection, effective
management, and/or recovery of mental health
conditions through coordination and integration
between primary and specialty care providers. In
line with the 2022 CMS Behavioral Health
Strategy, CMS is strengthening access to vital
behavioral health services. CMS is making it
easier for Medicare beneficiaries to get
behavioral health services, by allowing
behavioral health clinicians like licensed
professional counselors and marriage and family
therapists to offer services under the general
(rather than direct) supervision of the Medicare
practitioner. Medicare will pay for Opioid
Treatment Programs that use telecommunications
with patients to initiate treatment with
buprenorphine. CMS is also clarifying that Opioid
Treatment Programs can bill for opioid use
disorder treatment services provided through
mobile units, such as vans, in accordance with
Substance Abuse and Mental Health Services
Administration (SAMHSA) and Drug Enforcement
Administration (DEA) guidance.  These policies
may increase access in rural and other
underserved areas. CMS is also finalizing
policies to pay for clinical psychologists and
licensed clinical social workers to furnish
integrated behavioral health care as part of a
primary care team. Finally, Medicare will provide
a new monthly payment for comprehensive treatment
and management services for patients with chronic
pain. These new services offer a whole-person
approach to care.
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MPFS Strengthening Behavioral Health Billing for
2023
We referred recent CMS announcement regarding the
CY 2023 Medicare Physician Fee Schedule Final
Rule to discuss how MPFS is strengthening
behavioral health billing for 2023, you can refer
following links for a detailed understanding. Medi
cal Billers and Coders (MBC) is a leading medical
billing company providing complete revenue cycle
services. In such a revised behavioral health
billing environment, we can assist you in
receiving accurate reimbursement for delivered
services. To know more about our behavioral
billing and coding services, email us
at info_at_medicalbillersandcoders.com or call us
at 888-357-3226.   Reference  Calendar Year
(CY) 2023 Medicare Physician Fee Schedule Final
Rule HHS Finalizes Physician Payment Rule
Strengthening Access to Behavioral Health
Services and Whole-Person Care