Michael E. Nelson, MD, FCCP

Physicians from every specialty have stepped up in extraordinary ways during the pandemic; however, ABIM recognizes that pulmonary disease and critical care physicians, along with hospitalists and infectious disease specialists, have been especially burdened. ABIM has heard from many pulmonary disease and critical care medicine physicians asking for greater flexibility and choice in how they can maintain their board certifications.

For that reason, ABIM has extended deadlines for all Maintenance of Certification (MOC) requirements to 12/31/22 and to 2023 for Critical Care Medicine, Hospital Medicine, Infectious Disease, and Pulmonary Disease.
 

What assessment options does ABIM offer?

If you haven’t needed to take an MOC exam for a while, you might not be aware of ABIM’s current options and how they might work for you:

• The traditional, 10-year MOC assessment (a point-in-time exam taken at a test center)
• The new Longitudinal Knowledge Assessment (LKATM) (available in 12 specialties including Internal Medicine and Sleep Medicine now, and in Critical Care Medicine and Pulmonary Disease in 2023)

The 2-year Knowledge Check-In was retired at the end of 2021 with the introduction of the LKA.
 

How the new LKA works

As a longitudinal assessment, the LKA is designed to help you measure your medical knowledge over time and better melds assessment and learning. It consists of a 5-year cycle, during which you’ll be offered 30 questions each quarter, and need to open at least 500 out of 600 questions to meet the LKA Participation Requirement. You can choose not to open up to 100 questions over 5 years, allowing you to take breaks when you need them.

Once enrolled, you can take questions on your laptop, desktop, or smartphone. You’ll also be able to answer questions where and when it’s convenient for you, such as at your home or office – with no need to schedule an appointment or go to a test center. You can use all the same resources you use in practice – journals, apps, and your own personal notes—anything except another person. For most questions, you’ll find out immediately if your answer was correct or not, and you’ll receive a rationale explaining why, along with one or more references.

You’ll have 4 minutes to answer each question and can add extra time if needed by drawing from an annual 30-minute time bank. For each correct answer, you’ll earn 0.2 MOC points, and if you choose to participate in LKA for more than one of your certificates, you’ll have even more opportunities to earn points. In addition, beginning in your second year of participation, interim score reports will give you helpful information to let you know how you’re doing, so you can re-adjust your approach and focus your studies as needed. A pass/fail decision is made at the end of the 5-year cycle.
 

About eligibility

If you are currently certified in Critical Care Medicine or Pulmonary Disease and had an assessment due in 2020, 2021 or 2022, you don’t need to take an assessment this year and will be eligible to enroll in the LKA in 2023, or you can choose to take the traditional 10-year MOC exam.

Upon enrolling, you will continue to be reported as “Certified” as long as you are meeting the LKA Participation Requirement. If your next assessment isn’t due for a while, you will be able to enroll in the LKA in your assessment due year—not before then.

More information about eligibility can be found in a special section of ABIM’s website.
 

How much does it cost?

ABIM revised its MOC fees in 2022 to provide an option to pay less over time than previously, and the LKA will be included in your annual MOC fee at no additional cost. Here’s how it works:

In closing

Thousands of physicians have already started taking the LKA in 2022 and are reporting positive experiences with it. The ABIM is excited that physicians in additional disciplines, including Critical Care Medicine and Pulmonary Disease, will get to experience it themselves in 2023.

Physicians from every specialty have stepped up in extraordinary ways during the pandemic; however, ABIM recognizes that pulmonary disease and critical care physicians, along with hospitalists and infectious disease specialists, have been especially burdened. ABIM has heard from many pulmonary disease and critical care medicine physicians asking for greater flexibility and choice in how they can maintain their board certifications.

For that reason, ABIM has extended deadlines for all Maintenance of Certification (MOC) requirements to 12/31/22 and to 2023 for Critical Care Medicine, Hospital Medicine, Infectious Disease, and Pulmonary Disease.
 

What assessment options does ABIM offer?

If you haven’t needed to take an MOC exam for a while, you might not be aware of ABIM’s current options and how they might work for you:

• The traditional, 10-year MOC assessment (a point-in-time exam taken at a test center)
• The new Longitudinal Knowledge Assessment (LKATM) (available in 12 specialties including Internal Medicine and Sleep Medicine now, and in Critical Care Medicine and Pulmonary Disease in 2023)

The 2-year Knowledge Check-In was retired at the end of 2021 with the introduction of the LKA.
 

How the new LKA works

As a longitudinal assessment, the LKA is designed to help you measure your medical knowledge over time and better melds assessment and learning. It consists of a 5-year cycle, during which you’ll be offered 30 questions each quarter, and need to open at least 500 out of 600 questions to meet the LKA Participation Requirement. You can choose not to open up to 100 questions over 5 years, allowing you to take breaks when you need them.

Once enrolled, you can take questions on your laptop, desktop, or smartphone. You’ll also be able to answer questions where and when it’s convenient for you, such as at your home or office – with no need to schedule an appointment or go to a test center. You can use all the same resources you use in practice – journals, apps, and your own personal notes—anything except another person. For most questions, you’ll find out immediately if your answer was correct or not, and you’ll receive a rationale explaining why, along with one or more references.

You’ll have 4 minutes to answer each question and can add extra time if needed by drawing from an annual 30-minute time bank. For each correct answer, you’ll earn 0.2 MOC points, and if you choose to participate in LKA for more than one of your certificates, you’ll have even more opportunities to earn points. In addition, beginning in your second year of participation, interim score reports will give you helpful information to let you know how you’re doing, so you can re-adjust your approach and focus your studies as needed. A pass/fail decision is made at the end of the 5-year cycle.
 

About eligibility

If you are currently certified in Critical Care Medicine or Pulmonary Disease and had an assessment due in 2020, 2021 or 2022, you don’t need to take an assessment this year and will be eligible to enroll in the LKA in 2023, or you can choose to take the traditional 10-year MOC exam.

Upon enrolling, you will continue to be reported as “Certified” as long as you are meeting the LKA Participation Requirement. If your next assessment isn’t due for a while, you will be able to enroll in the LKA in your assessment due year—not before then.

More information about eligibility can be found in a special section of ABIM’s website.
 

How much does it cost?

ABIM revised its MOC fees in 2022 to provide an option to pay less over time than previously, and the LKA will be included in your annual MOC fee at no additional cost. Here’s how it works:

In closing

Thousands of physicians have already started taking the LKA in 2022 and are reporting positive experiences with it. The ABIM is excited that physicians in additional disciplines, including Critical Care Medicine and Pulmonary Disease, will get to experience it themselves in 2023.

Physicians from every specialty have stepped up in extraordinary ways during the pandemic; however, ABIM recognizes that pulmonary disease and critical care physicians, along with hospitalists and infectious disease specialists, have been especially burdened. ABIM has heard from many pulmonary disease and critical care medicine physicians asking for greater flexibility and choice in how they can maintain their board certifications.

For that reason, ABIM has extended deadlines for all Maintenance of Certification (MOC) requirements to 12/31/22 and to 2023 for Critical Care Medicine, Hospital Medicine, Infectious Disease, and Pulmonary Disease.
 

What assessment options does ABIM offer?

If you haven’t needed to take an MOC exam for a while, you might not be aware of ABIM’s current options and how they might work for you:

• The traditional, 10-year MOC assessment (a point-in-time exam taken at a test center)
• The new Longitudinal Knowledge Assessment (LKATM) (available in 12 specialties including Internal Medicine and Sleep Medicine now, and in Critical Care Medicine and Pulmonary Disease in 2023)

The 2-year Knowledge Check-In was retired at the end of 2021 with the introduction of the LKA.
 

How the new LKA works

As a longitudinal assessment, the LKA is designed to help you measure your medical knowledge over time and better melds assessment and learning. It consists of a 5-year cycle, during which you’ll be offered 30 questions each quarter, and need to open at least 500 out of 600 questions to meet the LKA Participation Requirement. You can choose not to open up to 100 questions over 5 years, allowing you to take breaks when you need them.

Once enrolled, you can take questions on your laptop, desktop, or smartphone. You’ll also be able to answer questions where and when it’s convenient for you, such as at your home or office – with no need to schedule an appointment or go to a test center. You can use all the same resources you use in practice – journals, apps, and your own personal notes—anything except another person. For most questions, you’ll find out immediately if your answer was correct or not, and you’ll receive a rationale explaining why, along with one or more references.

You’ll have 4 minutes to answer each question and can add extra time if needed by drawing from an annual 30-minute time bank. For each correct answer, you’ll earn 0.2 MOC points, and if you choose to participate in LKA for more than one of your certificates, you’ll have even more opportunities to earn points. In addition, beginning in your second year of participation, interim score reports will give you helpful information to let you know how you’re doing, so you can re-adjust your approach and focus your studies as needed. A pass/fail decision is made at the end of the 5-year cycle.
 

About eligibility

If you are currently certified in Critical Care Medicine or Pulmonary Disease and had an assessment due in 2020, 2021 or 2022, you don’t need to take an assessment this year and will be eligible to enroll in the LKA in 2023, or you can choose to take the traditional 10-year MOC exam.

Upon enrolling, you will continue to be reported as “Certified” as long as you are meeting the LKA Participation Requirement. If your next assessment isn’t due for a while, you will be able to enroll in the LKA in your assessment due year—not before then.

More information about eligibility can be found in a special section of ABIM’s website.
 

How much does it cost?

ABIM revised its MOC fees in 2022 to provide an option to pay less over time than previously, and the LKA will be included in your annual MOC fee at no additional cost. Here’s how it works:

In closing

Thousands of physicians have already started taking the LKA in 2022 and are reporting positive experiences with it. The ABIM is excited that physicians in additional disciplines, including Critical Care Medicine and Pulmonary Disease, will get to experience it themselves in 2023.

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

COVID-19 vaccination efforts were initially restricted to health department control, and physician practices were not often included as vaccination sites. However, as vaccine availability improves ,physician offices will become a place where vaccines can be delivered conveniently and efficiently. It is important to understand the current and future coding and billing requirements for COVID-19 vaccination so that one’s practice may be appropriately reimbursed.

The provision of COVID-19 vaccination in an office setting is not as simple as influenza or pneumonia vaccination. One can find useful information about all vaccines and specifically about COVID-19 vaccines at https://www.cdc.gov/vaccines/ed/index.html. This site includes video training modules and downloadable resources for clinical use, as well as patient education. This information is important as providing vaccinations may require a change in infrastructure, equipment, and clinical flow. It may not be financially advantageous for one’s practice to provide COVID-19 vaccination.

If the decision is made to provide COVID-19 vaccinations, there are specific CPT codes for each vaccine and its administration (Table 1). These codes are valid for the vaccines with emergency use authorization (Pfizer, Moderna, Janssen) but not yet for as yet unauthorized vaccines (AstraZeneca). Should additional vaccines be authorized, it is expected that new CPT codes will be added.

When a patient is vaccinated, only the administration code is used at this time. The CPT codes for the vaccine (91300-3) should not be used because the cost of the vaccine is currently born by the federal government. When the vaccines are available for purchase by a practice, it will then be appropriate to use the vaccine CPT code. If an evaluation and management (E/M) service is performed, the appropriate E/M service code should be reported in addition to the vaccine administration code.

For payment of the vaccine administration by Medicare, either a single claim or roster claim can be submitted. When five or more patients are vaccinated using the same vaccine on the same day, one may submit a roster claim. Instructions on how to appropriately bill the various Medicare plans can be found at https://tinyurl.com/hfya8888. Guidelines for payment by private insurers should also be reviewed as well, as they will have their own requirements. If a vaccine is given to an individual who does not have any insurance coverage, reimbursement may be available through the Provider Relief Fund. These funds were made available by legislation, including the CARES act and information about claim submittal for the uninsured can be found at https://www.hrsa.gov/CovidUninsuredClaim.

Physicians have asked for more flexible and convenient ways to maintain their ABIM Board certification and the recently announced longitudinal assessment option is being designed to accomplish these requests. It is anticipated to launch in 2022 in as many specialties as possible, allowing time prior to launch for engagement with the medical community to produce the best possible experience.

How will the new longitudinal assessment option be different? Question delivery will be structured to allow physicians greater ease of use and mobility, enabling access from virtually anywhere. Answer feedback will be immediate, and physicians will see the rationale behind the answer, along with links to educational material. The preferred pace for answering questions during each administration window will be determined by the examinee, and access to all the resources you use in practice, such as journals or websites, will also be allowed.
 

Engaging the community

As a Council member, I can attest to the fact that the ABIM has spent a lot of time thinking through key features that are “must haves” in the new option, but there are details that are still being defined. ABIM has prioritized engaging the community, and the suggestions, insights, and questions coming out of these efforts are being used to guide the development of the new longitudinal assessment option.

Following the initial announcement in August, nearly 1,400 physicians submitted comments about the new option. ABIM conducted 69 one-on-one interviews with board-certified physicians and ran user-testing on existing longitudinal assessment platforms from other Boards. ABIM staff attended society meetings throughout the fall and also assembled a Physician Advisory Panel of 11 physicians from members of our Community Insights Network. We want to ensure the features we are considering work well for physicians and provide the high quality experience they deserve.
 

How can you get involved?

Physicians interested in giving ABIM feedback are invited to connect with us through our Community Insights Network. By joining the Network, you’ll have an opportunity to share your ideas through surveys, interviews, and user tests and be a member of our online community “ABIM Engage.”

ABIM staff will also be in attendance at society meetings to provide individualized guidance and answer your questions. We had a booth at CHEST this past October, and you can find upcoming society meetings staff who will be attending on their website.
 

What Should You Do Now?

All current ABIM MOC program requirements and policies remain in effect, and ABIM will communicate any program changes well in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the options currently available in your discipline. 

Registration for all 2020 MOC assessments opened December 1, and physicians may have several pathways to choose from, including taking the Knowledge Check-In at home, office, or testing center or the traditional point-in-time assessment taken at a PearsonVUE center.

The next Knowledge Check-In in Pulmonary Disease will be offered in 2021. ABIM’s website lists the full schedule of available assessment options (https://tinyurl.com/t5bfg55). You can find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.

To keep up to date with developments in ABIM’s longitudinal assessment program, visit the new longitudinal FAQ webpage (https://tinyurl.com/u5bbdgw) that is updated as information becomes available.
 

Physicians have asked for more flexible and convenient ways to maintain their ABIM Board certification and the recently announced longitudinal assessment option is being designed to accomplish these requests. It is anticipated to launch in 2022 in as many specialties as possible, allowing time prior to launch for engagement with the medical community to produce the best possible experience.

How will the new longitudinal assessment option be different? Question delivery will be structured to allow physicians greater ease of use and mobility, enabling access from virtually anywhere. Answer feedback will be immediate, and physicians will see the rationale behind the answer, along with links to educational material. The preferred pace for answering questions during each administration window will be determined by the examinee, and access to all the resources you use in practice, such as journals or websites, will also be allowed.
 

Engaging the community

As a Council member, I can attest to the fact that the ABIM has spent a lot of time thinking through key features that are “must haves” in the new option, but there are details that are still being defined. ABIM has prioritized engaging the community, and the suggestions, insights, and questions coming out of these efforts are being used to guide the development of the new longitudinal assessment option.

Following the initial announcement in August, nearly 1,400 physicians submitted comments about the new option. ABIM conducted 69 one-on-one interviews with board-certified physicians and ran user-testing on existing longitudinal assessment platforms from other Boards. ABIM staff attended society meetings throughout the fall and also assembled a Physician Advisory Panel of 11 physicians from members of our Community Insights Network. We want to ensure the features we are considering work well for physicians and provide the high quality experience they deserve.
 

How can you get involved?

Physicians interested in giving ABIM feedback are invited to connect with us through our Community Insights Network. By joining the Network, you’ll have an opportunity to share your ideas through surveys, interviews, and user tests and be a member of our online community “ABIM Engage.”

ABIM staff will also be in attendance at society meetings to provide individualized guidance and answer your questions. We had a booth at CHEST this past October, and you can find upcoming society meetings staff who will be attending on their website.
 

What Should You Do Now?

All current ABIM MOC program requirements and policies remain in effect, and ABIM will communicate any program changes well in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the options currently available in your discipline. 

Registration for all 2020 MOC assessments opened December 1, and physicians may have several pathways to choose from, including taking the Knowledge Check-In at home, office, or testing center or the traditional point-in-time assessment taken at a PearsonVUE center.

The next Knowledge Check-In in Pulmonary Disease will be offered in 2021. ABIM’s website lists the full schedule of available assessment options (https://tinyurl.com/t5bfg55). You can find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.

To keep up to date with developments in ABIM’s longitudinal assessment program, visit the new longitudinal FAQ webpage (https://tinyurl.com/u5bbdgw) that is updated as information becomes available.
 

Physicians have asked for more flexible and convenient ways to maintain their ABIM Board certification and the recently announced longitudinal assessment option is being designed to accomplish these requests. It is anticipated to launch in 2022 in as many specialties as possible, allowing time prior to launch for engagement with the medical community to produce the best possible experience.

How will the new longitudinal assessment option be different? Question delivery will be structured to allow physicians greater ease of use and mobility, enabling access from virtually anywhere. Answer feedback will be immediate, and physicians will see the rationale behind the answer, along with links to educational material. The preferred pace for answering questions during each administration window will be determined by the examinee, and access to all the resources you use in practice, such as journals or websites, will also be allowed.
 

Engaging the community

As a Council member, I can attest to the fact that the ABIM has spent a lot of time thinking through key features that are “must haves” in the new option, but there are details that are still being defined. ABIM has prioritized engaging the community, and the suggestions, insights, and questions coming out of these efforts are being used to guide the development of the new longitudinal assessment option.

Following the initial announcement in August, nearly 1,400 physicians submitted comments about the new option. ABIM conducted 69 one-on-one interviews with board-certified physicians and ran user-testing on existing longitudinal assessment platforms from other Boards. ABIM staff attended society meetings throughout the fall and also assembled a Physician Advisory Panel of 11 physicians from members of our Community Insights Network. We want to ensure the features we are considering work well for physicians and provide the high quality experience they deserve.
 

How can you get involved?

Physicians interested in giving ABIM feedback are invited to connect with us through our Community Insights Network. By joining the Network, you’ll have an opportunity to share your ideas through surveys, interviews, and user tests and be a member of our online community “ABIM Engage.”

ABIM staff will also be in attendance at society meetings to provide individualized guidance and answer your questions. We had a booth at CHEST this past October, and you can find upcoming society meetings staff who will be attending on their website.
 

What Should You Do Now?

All current ABIM MOC program requirements and policies remain in effect, and ABIM will communicate any program changes well in advance of implementation. If you have an assessment due in 2020 or 2021, you can choose from the options currently available in your discipline. 

Registration for all 2020 MOC assessments opened December 1, and physicians may have several pathways to choose from, including taking the Knowledge Check-In at home, office, or testing center or the traditional point-in-time assessment taken at a PearsonVUE center.

The next Knowledge Check-In in Pulmonary Disease will be offered in 2021. ABIM’s website lists the full schedule of available assessment options (https://tinyurl.com/t5bfg55). You can find all of your MOC program requirements and deadlines by signing into your Physician Portal at abim.org.

To keep up to date with developments in ABIM’s longitudinal assessment program, visit the new longitudinal FAQ webpage (https://tinyurl.com/u5bbdgw) that is updated as information becomes available.