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December 23, 2020 | CMS Increases Focus on Telehealth as Global Pandemic Continues

As 2020 draws to a close, the COVID-19 pandemic remains a catalyst for change – ushering in a new telehealth-based era of primary care. This dynamic is evident in the 2021 fee schedule changes recently released by CMS.

Notable changes to the fee schedule include:

Despite the decrease in CCM reimbursement, CMS has indicated that the net effect of all of these changes will be a 13% average overall increase in Medicare allowed charges in 2021.

Wellbox has completed an initial analysis of our current populations and the data indicates that a significant opportunity exists for providers to mitigate their CCM revenue loss by increasing their population under care management. We estimate that the addition of PCM services will increase the average eligible population by 20%. In addition to mitigating the revenue loss, the expansion of the care management population expands preventative care services to patients who are certain to benefit from one-on-one nursing care driving additional improvements in clinical outcomes.

Wellbox will begin offering PCM services, in addition to CCM, RPM, and AWV, in January.  We look forward to the opportunity to help more people manage their chronic illness(es) with high-quality, high-touch preventative care and to continue to support healthcare providers as the industry continues to transition to a telehealth supported model.

The changes will be effective for services furnished on or after January 1, 2021.  The full final rule is available here.

If you have additional questions or would like to implement care management or remote monitoring in 2021, please contact us here.