Centers for Medicare & Medicaid Services Purportedly Acknowledges Medical Cannabis

In an unpublished rule filed by the Centers for Medicare & Medicaid Services on Nov. 2, 2022, CMS seems to jump aboard the medical cannabis train that is currently plowing through the U.S. This rule, titled “Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies,” is scheduled to publish on the Federal Register Nov. 18, 2022.

CMS tackles Healthcare Common Procedure Coding System (HCPCS) codes G3002 and G3003, and it provides a finalized descriptor for these codes, which includes medication management and complementary and integrative approaches. CMS clarifies that medication management includes any other substances the person with chronic pain might be using for any purpose. CMS states that complementary and integrative approaches are added to the HCPCS code G3002 and G3003 descriptors because physicians and other health care practitioners should be able to coordinate pain care across a range of treatments and therapies for a beneficiary.

When responding to comments about chronic pain and updates to codes G3002 and G3003, CMS explicitly acknowledges that some individuals with pain may also be using substances such as cannabis and other plant-based treatments for pain. CMS then states that they believe this type of medication management, if applicable, should be billed under HCPCS code G3002 for beneficiaries with chronic pain.

Key takeaways:

• CMS acknowledges chronic pain patients are using cannabis to treat their pain.

• CMS seems to contemplate allowing healthcare practitioners to bill for medication management, including medical cannabis, under HCPCS code G3002.

If you have any questions about how this development could affect you, please contact HAT Law’s Medical Cannabis Legal Team.

Julie Mitchell, J.D., L.L.M., jmitchell@hatlawfirm.com, 601-842-1074