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Physician Fee Schedule Proposed Rule Listening Session: Register Now
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Thursday, August 6, 2020



MLN Matters® Articles

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Electronic Prescribing of Controlled Substances in Medicare Part D: Request for Information

CMS released a Request for Information (RFI) for Electronic Prescribing of Controlled Substances in Medicare Part D. The RFI seeks input from stakeholders around implementation of Section 2003 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act), which generally requires that prescriptions for controlled substances covered under a Medicare Part D prescription drug plan be transmitted by a health care practitioner electronically.

Comments are due by October 5.


Release of the IRF Web Pricer

Providers and other payers use PC Pricer applications to estimate Medicare payments. Over the next year, CMS will stop producing new versions of the downloadable PC Pricers and issue them as web-based applications. 

The first web application to be released is the Inpatient Rehabilitation Facility (IRF) Web Pricer. For the best user experience, access this Web Pricer through Google Chrome. You may also access it through Microsoft Edge or Mozilla Firefox. Microsoft Internet Explorer is not supported.


Subsequent Nursing Facility E/M Services: Comparative Billing Report

CMS issued a Comparative Billing Report (CBR) on Subsequent Nursing Facility Evaluation and Management (E/M) Services, focusing on providers who submit Medicare Part B claims. These reports contain data-driven tables with an explanation of findings that compare your billing and payment patterns to those of your peers in your state and across the nation.

CBRs are not publicly available. Look for an email from cbrpepper.noreply@religroupinc.com to access your report. Update your email address in the Provider Enrollment, Chain, and Ownership System to ensure accurate delivery.

For More Information:


Nursing Home Compare Refresh

The July 2020 Nursing Home Compare refresh is available, including quality measure results based on Skilled Nursing Facility (SNF) Quality Reporting Program data. Visit the Nursing Home Compare website to view the data.

For More Information:


Medicare Ground Ambulance Data Collection System: Updated Documents

On July 31, CMS posted updated versions of the following Medicare Ground Ambulance Data Collection System resources:

For more information, see the Ambulances Services Center website.


MACs Resume Medical Review on a Post-Payment Basis

To protect the Medicare Trust Fund against inappropriate payments, Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17, the MACs are resuming with post-payment reviews of items/services provided before March 1, 2020. The Targeted Probe and Educate program (intensive education to assess provider compliance through up to three rounds of review) will restart later. The MACs will continue to offer detailed review decisions and education as appropriate.


Renewed ABN: Deadline Extended to January 1

Due to COVID-19, CMS extended the deadline for using the renewed Advance Beneficiary Notice of Noncoverage (ABN) until January 1, 2021. You may use the renewed form prior to the mandatory deadline. 


COVID-19: Telemedicine, Clinical Experiences, Resources for Hospitals and Urgent Care Centers

The Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) released an Express message that includes: 

For More Information:


Protect Your Patients Against Vaccine-Preventable Diseases

National Immunization Awareness Month (NIAM) is an annual observance, highlighting the importance of vaccinations. Protect your Medicare patients:

  • You have the power to protect your patients against serious diseases like pneumococcal disease and seasonal flu
  • Your recommendation can make a difference. You are the most valued and trusted source of health information for adults.
  • Even if your practice does not administer or stock certain vaccines, make a strong recommendation and refer patients to other vaccine providers. Follow up to ensure vaccination.

Medicare Part B covers the following vaccines:

More Information:

Visit the Preventive Services website to learn more about Medicare-covered services.



National CMS/CDC Nursing Home COVID-19 Training Series Webcast — August 6

COVID-19 Surveillance to Enable Early Detection and Response to Outbreaks: National Healthcare Safety Network Mandatory Data Collection

Thursday, August 6 from 4 to 5 pm ET

Register for this webcast.

Join CMS and the Centers for Disease Control and Prevention (CDC) to learn about federal guidance, reporting requirements, as well as the importance of conducting regular outcome and process surveillance.

Miss a training? View recordings, slides, and resources on QIOProgram.org.


COVID-19: Lessons from the Front Lines Call — August 7

Friday, August 7 from 12:30 to 2 pm ET

These calls are a joint effort between CMS Administrator Seema Verma, Food and Drug Administration Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians: Share your experience, ideas, strategies, and insights related to your COVID-19 response. There is an opportunity to ask questions.

To Participate:

  • Conference lines are limited; we encourage you to join via audio webcast
  • Or, call 833-614-0820; Access Code: 4695240

For More Information:

Target Audience: Physicians and other clinicians.


Physician Fee Schedule Proposed Rule: Understanding 4 Key Topics Listening Session — August 13

Thursday, August 13 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

Proposed changes to the CY 2021 Physician Fee Schedule are aimed at reducing burden, recognizing clinicians for the time they spend taking care of patients, removing unnecessary measures, and making it easier for clinicians to be on the path towards value-based care. During this listening session, CMS experts briefly cover provisions from the proposed rule and address your clarifying questions to help you formulate your written comments for formal submission: 

  • Extending telehealth and licensing flexibilities beyond the public health emergency
  • Updating Evaluation and Management (E/M) coding guidance
  • Updating the Quality Payment Program/MIPS Value Pathways
  • Updating opioid use disorder/substance use disorder provisions

We encourage you to review the following materials prior to the call:

Note: feedback received during this listening session is not a substitute for your formal comments on the rule. See the proposed rule for information on submitting these comments by October 5.

Target Audience: Medicare Part B fee-for-service clinicians; office managers and administrators; state and national associations that represent health care providers; and other stakeholders.


Dr. Todd Graham Pain Management Study Listening Session — August 27

Thursday, August 27 from 1:30 to 3 pm ET

Register for Medicare Learning Network events.

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) outlines national strategies to help address the nation’s opioid crisis. Clinicians and health care systems need information about multimodal pain care options in outpatient and inpatient settings to effectively treat Medicare patients with acute or chronic pain, including complementary care, analgesic medications, and medical devices. The Dr. Todd Graham Pain Management Study will give CMS important information about treatment and outcomes and help us understand the roles of behavioral health, specialty care integration, care planning, health disparities in pain, opioid use, and opioid use disorders treatment. 

CMS wants your feedback on:

  • What evidence-based treatments, technologies, and models should Medicare cover that it currently does not?
  • What barriers impede Medicare clinicians and beneficiaries from utilizing non-opioid treatments and technologies to help treat acute and chronic pain?
  • How can Medicare improve care for beneficiaries with pain who have a current or past history of mental or substance use disorder(s) or are at higher risk for these conditions, including people at increased suicide risk?
  • How has the COVID-19 public health emergency, including federal waivers and other flexibilities, impacted your ability to treat pain in Medicare beneficiaries and their access to pain treatment?

Target Audience: Clinicians and state and national associations that represent health care providers.


MLN Matters® Articles

New Waived Tests

CMS issued a new MLN Matters Article MM11916 on New Waived Tests (PDF). Learn about new Clinical Laboratory Improvement Amendments of 1988 waived tests approved by the Food and Drug Administration.


Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation

CMS issued a new MLN Matters Article MM11855 on Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation (PDF). Learn about CY 2021 home health RAP payment policies.


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