2014 Health Care Services Rules and Fee Schedule Will Be Effective 12/26/2014

December 18, 2014

The 2014 Health Care Services Rules and Fee Schedule will be effective on December 26, 2014, and will replace the current 2012 fee schedule. The updated rules, manual, and fee schedule worksheets will also be posted and available for your use on the 26th. Here are some of the highlights of the updated rule language:

  • New rule on billing for vaccines and toxoids in an office setting
  • New rules covering reimbursement for opioid treatment for chronic, non-cancer pain
  • New rule regarding reimbursement for custom compound topical medications
  • Adjusted conversion factor for physician services
  • Updated source documents
  • New definitions of biologicals, custom compound medications, and opioid drugs
  • Updated language on proper coding procedures for mental health services
  • Multiple procedure policy updates for multiple radiology procedures in line with Medicare
  • Revised rules regarding reimbursement for dispensed medications and durable medical equipment and supplies.

As always, we welcome your comments and questions. Please feel free to contact the agency on our toll-free line at 1-888-396-5041.