On August 3, 2020, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2021 Medicare Physician Fee Schedule Proposed Rule (CY 2021 PFS Proposed Rule). 

In response to the COVID-19 pandemic, CMS issued Interim Final Rules in March and May 2020, implementing temporary regulatory flexibilities tied to the duration of the Public Health Emergency (PHE). CMS is soliciting comments on whether the following temporary policies should be extended through the end of the calendar year in which the COVID-19 PHE ends, or potentially beyond.

• Allowing audio-visual telecommunications technology presence to fulfill requirements to be present for key and critical portions of the service as needed for the teaching physician to receive payment for services furnished with residents.
• Allowing teaching physicians who involve residents in providing care at primary care centers under the primary care exception to provide the necessary direction, management and review for the residents’ services using audio/video real-time communications technology.
• Expanding the set of services residents at primary care centers may furnish to beneficiaries to include levels 4-5 of an office/outpatient evaluation and management (E/M) visit, care management, and communications technology-based services.
• Allowing the requirement for the presence of the teaching physician during a psychiatric service or the interpretation of diagnostic tests performed by a resident to be met by the teaching physician’s supervision using audio/video real-time communications technology.
• Allowing residents to furnish and separately bill for physicians’ services outside the scope of their approved GME program (i.e., moonlight) in the inpatient department of the hospital in which they train in the their approved GME program.

CMS is seeking stakeholder comments on whether to extend these policies on a temporary basis to allow for a transition policy to return to the pre-COVID policies. In the long term, CMS may consider whether to continue the policies on a permanent basis, even after the PHE ends.  

Commenters should submit comments on whether CMS should continue any or all of these policies by October 5, 2020. Please feel free to contact the GME@Dentons team listed above if you have questions about these proposed policies or other proposals in the CY 2021 PFS Proposed Rule.