CMS released a proposed rule requiring written documentation of face-to-face encounters between physicians (and mid-level providers) and patients for certain high-risk durable medical equipment (DME) in the 2013 Proposed Physician Fee Schedule. CMS expects that face-to-face encounters will decrease the number of fraudulent and inappropriate claims by DME suppliers. The increased encounters should result in increased Medicare Part B funds spent on additional physician visits; however, CMS expects to save Part B funds by preventing fraudulent and inappropriate Medicare Part B payments to DME suppliers. Physicians, DME suppliers, and other health care providers may comment on the proposed regulations until September 30, 2012.
According to the proposed rule a DME supplier will be reimbursed by Medicare for certain high-risk DME ("Specified Covered Items") only if a face-to-face encounter has occurred between the physician or mid-level practitioner (physician's assistant, nurse-practitioner or clinical nurse specialist) and the patient and the encounter has been documented. The DME supplier must receive and maintain both the DME order and the documentation of the encounter for at least seven years.
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