February 2022 Federal Advocacy Update

Congressional Update:

  • In February, Congress must pass a continuing resolution (CR) to keep the government running. President Biden will also be dropping the 2023 federal budget in February.
  • Congress needs to address the PTA/OTA differential. H.R. 5536, the SMART Act, will address this. Make sure you are sending letters to your representatives on this issue as we hoping to get this bill included in the CR.
  • The Allied Health Workforce Diversity Act (H.R. 3320), passed out of committee around Thanksgiving and may be eligible for a vote soon. We are doing targeted grassroots and work here in Washington. We need more Republican cosponsors in the House.
  • Medicare sequestration moratorium may be considered due to the omicron surge.
  • We anticipate that the public health emergency (PHE) will continue through the end of 2022. We are not sure at this time what criteria of the pandemic will end the PHE.

Regulatory Update:

  • Telehealth POS Codes Update
    • CMS is revising the description of POS code 02 and creating a new POS code 10 for billing for services using telehealth:
      • POS 02: Telehealth Provided Other than in Patient’s Home
      • POS 10: Telehealth Provided in Patient’s Home
    • Effective Jan. 1, with Medicare contractors processing codes starting April 4.
    • During PHE
      • When billing telehealth claims for services delivered on or after March 1, 2020, and for the duration of the COVID-19 emergency declaration:
      • Include Place of Service (POS) equal to what it would have been had the service been furnished in person.
      • Append modifier 95 to indicate the service took place via telehealth.
    • After PHE:
      • Any change of policy regarding use of telehealth POS codes following the end of the PHE would be addressed in subsequent instruction.
      • Medicare contractors are to instruct their providers to continue to bill according to current applicable rules.
  • CMS Update on DMEPOS Master List Update
    • Issued Jan. 13
    • Updates master list of DMEPOS requiring prior authorization, face-to face encounters, or written orders
    • Includes dressings, pneumatic compressors, several types of neuromuscular stimulators, manual wheelchair accessories, power wheelchairs and parts, and multiple orthoses
    • Updates effective April 13, with prior authorization phased in from April 13 – Oct.10