The Calendar Year (CY) 2022 Physician Fee Schedule final rule includes information for Medicare-enrolled Opioid Treatment Programs (OTPs):
- After the end of the COVID-19 public health emergency (PHE), CMS will allow audio-only interactions (like telephone calls) when audio-video communication isn’t available to the patient or the patient can’t or won’t agree to 2-way audio-video communication
- CMS established HCPCS code G1028 for a higher dose of naloxone hydrochloride nasal spray in response to the increase in overdoses from illicitly-manufactured fentanyl, which can require a more potent overdose reversal drug
After the PHE ends, CMS expects OTPs to add the following modifiers on claims for HCPCS code G2080:
- Modifier 95: for counseling and therapy provided using audio-video telecommunications
- Modifier FQ: for counseling and therapy provided using audio-only telecommunications
Additionally, CMS issued an interim final rule with comment period to keep the methadone payment amount at the CY 2021 rate for the duration of CY 2022. We encourage OTPs to review the rule and submit formal comments by January 3, 2022.
CMS updated the OTP webpages and the Billing & Payment booklet with this and other new information.
