EEG2020 November 2019 Update

On November 1, just in time for the start of Epilepsy Awareness Month, CMS issued a final rule on the 2020 Physician Fee Schedule, which goes into effect on January 1, 2020.

After taking in all of the commentary, CMS announced the decision to postpone national pricing for CY 2020 for TC Long Term EEG Monitoring codes, in favor of “finalizing the assignment of contractor pricing.” This delay will allow them additional time to gather more data and feedback from interested stakeholders.

This ruling has been positively impacted by the education we provided elected officials and CMS on the proposed changes to long-term video EEG (vEEG) monitoring, and the gaps in valuation of these services.

More Work Is Needed

CMS is seeking additional information that will address concerns about the resources involved in furnishing these services: “We urge interested stakeholders to consider submitting robust data regarding direct PE resource inputs and costs involved in furnishing these and other services for our consideration for future rulemaking.” They especially seek “empirical data, regarding the resources involved in furnishing PFS services.”

Their decision goes a long way toward ensuring access to care for some of the most vulnerable patients suffering from epilepsy. All of the professional societies, organizations, physicians, technologists, patients, and their families who entered comments for CMS and contacted their legislators deserve great credit for making a difference.

To learn more and view CMS’ memo in its entirety, click here.

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