This past November, CMS announced that starting January 1, 2023, Medicare can pay physicians in all states and other practitioners with prescription authority reminiscent of Nurse Practitioners (NP’s) and Physician Assistants (PA’s) in some states, to perform comprehensive pain management for his or her patients living with chronic pain. Medicare medical insurance covers individuals over the age of 65 and disabled Americans.
CMS has created two specialized billing codes only for chronic pain management (CPM codes G3002 and G3003) that these healthcare practitioners can use to receives a commission for his or her time spent caring for patients and coordinating patient care with other healthcare practitioners reminiscent of physical therapists, psychologists and even complementary practitioners reminiscent of massage therapists and acupuncturists.
How will this improve pain care?
Individuals with pain have had a difficult time finding physicians that can look after them. Chronic pain is complex and lots of physicians are reluctant to spend the time required to seek out the proper treatments for them. Further, doctors often lack the training to know concerning the full range of options available to administer chronic pain in addition to the most effective option to assess pain and create treatment plans for patients.
CMS’s recent codes require doctors to spend at the least half-hour with the patient monthly and doctors can add an infinite period of time to that in 15-minute increments. CMS can pay for monthly visits if that’s what is required. As well as, CMS has specified what tasks physicians must perform that comprise comprehensive pain management although they don’t require that each task be performed for each patient. The tasks include diagnosis, assessment, the event and revision of a care plan and on-going communication and coordination with other essential practitioners involved in your pain care, to call a couple of.
How will I do know if my doctor is using this code?
CMS is requiring the physician, PA or NP to acquire the patient’s consent and document it within the record prior to billing this code for the primary time.
Do the brand new codes allow telehealth visits with my doctor?
CMS is requiring that the initial visit along with your doctor using the brand new codes is in person but any subsequent visits could also be conducted using telehealth.
What about if I even have already been seeing a physician for pain management and have an on-going treatment plan?
CMS isn’t requiring that each task be accomplished with every patient. They’ve stated that they don’t expect that each element of the code will probably be appropriate for each patient. The brand new codes do include revision and maintenance of the care plan so these ongoing visits needs to be covered.
Will any doctor no matter specialty have the opportunity to bill these recent CPM (chronic pain management) codes?
Yes. The codes may be utilized by any licensed physician including primary care providers, pain management specialists, physiatrists, neurologists and lots of other physician specialties who treat individuals living with chronic pain.
Will other private and non-private insurers cover monthly chronic pain management visits?
These codes and this coverage decision only applies to Medicare beneficiaries. Nevertheless, private insurers often follow Medicare’s lead in order that they may determine to supply similar coverage in the longer term.
Should I mention this to my doctor?
Yes. We recommend that you simply do mention it in case your doctor doesn’t find out about this recent type of payment for chronic pain management visits by patients with Medicare coverage.
