In a recent news bite from the Coalition to Advance Palliative Care (CAPC), there have been modest changes to continue to reinforce person-centered care with a focus on preventative activities.
“The Centers for Medicare & Medicaid Services (CMS) has released the final rule for the CY 2025 Medicare Physician Fee Schedule. While this year’s rule does not contain the same level of innovation as previous years, some modest changes continue to improve clinicians’ capacity to care for people living with serious illness. CMS is finalizing its proposal to establish new coding and payment for caregiver training (G0541, G0542, and G0543), and added the caregiver training codes to the Medicare Telehealth Services list (CPT 97550 and 97551). CMS will now also allow payment for the relatively new complexity add-on code, G2211, on the same day as an annual wellness visit, vaccine administration, or any Medicare Part B preventive services that is reported by the same practitioner.
CMS is also finalizing new Merit-based Incentive System (MIPS) Value Pathways, five of which include the measure “Ambulatory Palliative Care Patients’ Experience of Feeling Heard and Understood”:
- Advancing Care for Heart Disease MVP
- Coordinating Stroke Care to Promote Prevention and Cultivate Positive Outcomes MVP
- Optimal Care for Kidney Health MVP
- Quality Care for Patients with Neurological Conditions MVP
- Advancing Cancer Care MVP
Finally, CMS is finalizing three new Advanced Primary Care Management codes, which reflect key considerations such as 24/7 access and continuity of care, comprehensive care management, and patient-centered comprehensive care plan. These new codes are tied to the level of patient medical and social complexity and are not time-based.
For CY 2025, CMS reduces the conversion factor by 2.83%. However, there is legislation proposed to eliminate this cut and replace it with an increase.”
