Medicare Billing and Coding Update (Archive 11/9/2022)

1.0 CME / 1.0 CMD Management

The 2023 revisions to current procedural terminology (CPT) evaluation and management services, including those for nursing facility services and assisted living facility services, will be among the most significant changes to CPT descriptors in decades. This webinar will focus on those changes as well as other important aspects of documentation and coding in PALTC. The goal of this webinar is to help prepare participants to implement 2023 coding and documentation guidance for CPT evaluation and management services in PALTC. 

Learning Objectives

By the end of the webinar, participants should be able to 

• Describe the revised evaluation and management guidelines for the nursing facility, home, and residence. 
• Discuss the revisions to medical decision-making criteria.
• Recognize the various prolonged service codes.
• Explain the distinction between CMS payment policy and federal statutory regulations.

Speaker Information:

Charles Crecelius, MD, PhD, CMD, is the director, post-acute care services for the BJC Medical Group ACO, multi-facility medical director for Delmar Gardens Enterprises, and associate clinical professor of internal medicine and geriatrics at Washington University School of Medicine. He is a past president of AMDA – The Society for PALTC Medicine, represents the Society in the American College of Physician’s Subspecialty Advisory Group on Socioeconomic Affairs and the AMA Relative Value Update Committee, and is on the Steering Committee of the Practice Management Section.

Robert Zorowitz, MD, MBA, CMD, is regional vice president, health affairs, for the Northeast at Humana. A graduate of Albany Medical College, he completed a residency in internal medicine at Long Island Jewish Medical Center and a fellowship in geriatric medicine at Mt. Sinai School of Medicine. He received his MBA from the Goizueta Business School of Emory University. He is board certified in internal medicine, geriatric medicine, hospice/palliative medicine and is a Certified Medical Director in post-acute and long-term care. Over the years, his practice took him to the office, hospital, and PALTC settings. For the last 15 years, he has been the American Geriatrics Society advisor to the American Medical Association's CPT Editorial Panel.

Credit Information:

Activity Created 11/2022

Credits Available Until 11/2025

Credit Statements: 

CME: AMDA – The Society for Post-Acute and Long-Term Care Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDA – The Society for Post-Acute and Long-Term Care Medicine for Post-Acute and Long-Term Care Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CMD: This self-study activity has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for a total of 1.0 management hours toward certification or recertification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. The CMD program is administered by the ABPLM. Each physician should claim only those hours of credit actually spent on the activity.

Visit the Continuing Education page for information on if and how you can claim credit/hours for AMDA’s education.

Disclosure Information:

The Society requires the disclosure of all speaker/faculty/planner’s relevant financial relationships; presence of off-label use of a device or medication; and discussion of any experimental, new or evolving topic prior to each accredited education activity.

If the learner perceives any bias toward a commercial product or service, advocation of unscientific approaches to diagnosis or therapy, or recommendation, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients please report this to the Society’s staff.

All relevant financial relationships have been identified, mitigated, and resolved.

All relationships have been identified, mitigated, and resolved. 

The following AMDA Online Education Subcommittee members have financial relationships to report: Diane Sanders-Cepeda, DO, CMD – Employee: UHG; UHC Retiree Solutions E&I; all others have no relationships to disclose.   

The speakers have no financial relationships to disclose.

AMDA staff have no financial relationships to disclose.