CMS has asked for feedback on a number of questions they have about the use of these new CPM codes. We have selected some of the most important questions for patients to answer, if you choose to do so. They are:
- Duration of physician visits?
CMS has proposed 30 minutes for each monthly appointment with the ability to add on 15 minutes per month. CMS wants to know if you think they should allow for more time and suggested 45 minutes or an hour monthly for physician visits, with the ability to add on 20 minutes more per month.
- Newly diagnosed vs long time chronic pain patient?
Should CMS allow the same amount of time for physician visits when a patient is first diagnosed with chronic pain in that visit as they do for a person who has lived with chronic pain for a long time and is seeing a new physician?
- Face-to-face vs telehealth?
CMS has proposed that the first visit with a new physician should be in person and subsequent visits would be allowed by telehealth as an option. They want to know what you think. Should all visits be allowed to use telehealth or should they be required to be in person?
Should physicians be required to get the patient’s verbal consent before using the CPM code? Use of the CPM code would mean that physicians would have to perform the services that comprise the code. CMS also would like to know if the doctor should be required to get the patient’s verbal consent on every visit or just the first visit?
CMS has also asked if specialists or therapists, such as physical therapists who the patient sees for treatment as part of the plan, should be required to get the patient’s verbal consent prior to treatment?
- Are any services missing?
The list of services that CMS has included in the proposed new CPM main code, GYYY1, include: diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and maintenance of a person-centered care plan that includes strengths, goals, clinical needs, and desired outcomes; overall treatment management; facilitation and coordination of any necessary behavioral health treatment; medication management; pain and health literacy counseling*; crisis care; and ongoing communication and care coordination between relevant practitioners furnishing care (e.g. physical therapy).
CMS defines health literacy counseling as the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.)
CMS would like to know if any other services should be included in the new CPM code or if any listed should be eliminated?
- What other providers does your doctor need to coordinate with?
CMS would like information on what other service providers, therapists or specialists your doctor will need to coordinate your care with and what that coordination involves. For example, you may be referred to a medical specialist such as a headache specialist or your doctor may recommend that you see a massage therapist, acupuncturist or yoga practitioner. That coordination may involve the exchange and review of test results or review and discussion of reports from the therapist about what progress s/he has made in improving your functioning or reducing your pain. CMS wants to know about that. CMS may want to be sure your doctor is properly compensated for time spent coordinating your care.