…of Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) for APIs 2. Privacy and Security Concerns in the Context of APIs 3. Specific Technical Approach and Standards B. Content and Vocabulary Standards C. Application Programming Interface (API) Standard D. Upd…

…-Time Prescription Benefit Criterion (d) New Certification Criteria for Modular API Capabilities (e) New Certification Criteria for Electronic Prior Authorization 3. Summary of Costs and Benefits B. Background Summary 1. Acute Care Hospital Inpatient Prospective Payment System (I…

…nt Notice final rule, established a methodology for estimating the average per capita premium for purposes of calculating the premium adjustment percentage. Beginning with the 2015 benefit year, the premium adjustment percentage was calculated based on the estimates and projectio…

…nt Notice final rule, established a methodology for estimating the average per capita premium for purposes of calculating the premium adjustment percentage. Beginning with the 2015 benefit year, the premium adjustment percentage was calculated based on the estimates and projectio…

…d Services To Treat Systemic Autoimmune Disease Requiring Immunosuppressive Therapies a. Consideration of Dental Services That May Be Inextricably Linked to Covered Services for the Treatment of Systemic Autoimmune Disease Requiring Immunosuppressive Therapies 5. Implementation o…

…the IPPS for Operating Costs 4. Proposed FY 2021 Policy Governing the IPPS for Capital-Related Costs 5. Proposed Changes to the Payment Rates for Certain Excluded Hospitals: Rate-of-Increase Percentages 6. Proposed Changes to the LTCH PPS 7. Proposed Changes Relating to Quality D…

…the IPPS for Operating Costs 4. Proposed FY 2021 Policy Governing the IPPS for Capital-Related Costs 5. Proposed Changes to the Payment Rates for Certain Excluded Hospitals: Rate-of-Increase Percentages 6. Proposed Changes to the LTCH PPS 7. Proposed Changes Relating to Quality D…

…ervices in Private Practices (a) Remote Therapeutic Monitoring for Physical Therapists and Occupational Therapists in Private Practice (b) General Supervision for PTs and OTs in Private Practice Comment Solicitation 2. KX Modifier Thresholds 3. Diabetes Self-Management Training (…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

… Analogous to Office/Outpatient E/M Visits (1) End-Stage Renal Disease Monthly Capitation Payment Services 2. TCM Services (CPT Codes 99495 and 99496) 3. Maternity Services 4. Assessment and Care Planning for Patients With Cognitive Impairment (CPT Code 99483) 5. Initial Preventi…

…ical therapy services that are provided, in whole or in part, by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). Section 1834(v)(2)(A) of the Act required CMS to establish modifiers to identify these services, which we did in the CY 2019 PFS final ru…

…80504, 80505, and 80506) (29) Revaluing End-Stage Renal Disease (ESRD) Monthly Capitation Payment Services (MCP) (CPT Code 90954) (30) Colon Capsule Endoscopy (CPT Codes 91110, 91111, and 91113) (31) External Cardiovascular Device Monitoring (CPT Codes 93228 and 93229) (32) Elect…

…ge 5794) Standards and 255 Guidelines, technology has continued to evolve at a rapid pace. Pursuant to our statutory mandate, the Access Board deemed it necessary and appropriate to review and update the existing 508 Standards and 255 Guidelines in order to make them consistent w…

…n 1852(m)(2)(A)(ii) of the Act excludes from MA additional telehealth benefits capital and infrastructure costs and investments relating to such benefits. These statutory provisions have guided our rule. In this final rule, we establish regulatory requirements that will allow MA …