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2021 LCD Updates

Posted by Billy Kanter, CPED on Nov 30, 2020 12:33:17 PM
Billy Kanter, CPED
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2021 LCD Updates

On November 5, The Centers for Medicare & Medicaid Services, CMS, released some very exciting updates relating to the Therapeutic Shoe Program, and more specifically, the documentation requirements of the Certifying Physician (MD/DO).

This update will allow for the delegation of some of the comprehensive management of diabetes responsibilities from the MD/DO to nurse practitioners (NP) and/or physician assistants (PA). This clarification is specific to NPs and PAs who are practicing under the supervision of an MD or DO, and does not include NPs/PAs who practice independently and bill under their own NPI.

The effective date for this change is January 1, 2021 and will only apply to providers in one of the Primary Care First regions. Unfortunately, the only locations covered under the Primary Care First model are –

  • Alaska (statewide)
  • Arkansas (statewide)
  • California (statewide)
  • Colorado (statewide)
  • Delaware (statewide)
  • Florida (statewide)
  • Greater Buffalo region (New York)
  • Greater Kansas City region (Kansas and Missouri)
  • Greater Philadelphia region (Pennsylvania)
  • Hawaii (statewide)
  • Louisiana (statewide)
  • Maine (statewide)
  • Massachusetts (statewide)
  • Michigan (statewide)
  • Montana (statewide)
  • Nebraska (statewide)
  • New Hampshire (statewide)
  • New Jersey (statewide)
  • North Dakota (statewide)
  • North Hudson-Capital region (New York)
  • Ohio and Northern Kentucky region (statewide in Ohio and partial state in Kentucky)
  • Oklahoma (statewide)
  • Oregon (statewide)
  • Rhode Island (statewide)
  • Tennessee (statewide)
  • Virginia (statewide).

We’re hoping that, assuming everything goes well, this policy will be extended nationwide. Stay-tuned for more updates once we have them!

For additional information pertaining to this update, you can find the press releases by CMS below:

 

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Topics: Medicare Paperwork, Practitioner

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