News & Media
Time running out to comment on CY 2019 Medicare Reimbursement Changes
The deadline to comment on the CY 2019 Medicare Physician Fee Schedule Proposed Rule ends on September 10, 2018. This proposed rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2019. MSMS staff is currently preparing comments for submission and encourages you to share examples of how the proposed rule may negatively or positively impact your practice by emailing them to Stacey Hettiger.
The Centers for Medicare and Medicaid Services (CMS) is proposing several updates and new proposals affecting the payment rates. These proposals include, but are not limited to, 1) changes to office/outpatient Evaluation and Management (E/M) visit documentation, coding and payment, 2) payment for services provided through the use of communication technology such as virtual check-in and specified remote evaluation and monitoring, separately for two newly defined physicians’ services furnished using communication technology, 3) adding HCPCS codes G0513 and G0514 to the list of telehealth services, 4) changing the way Medicare Advantage payments are treated in the definition of “applicable laboratories” under the clinical laboratory fee schedule and seeking comment on alternative approaches to for defining “applicable laboratories,” and 5) further aligning CMS’ value-based payment initiatives with other programs and shared goals while focusing less on low-value or low-priority measures and more on interoperability of electronic health records and measures and incentives that potentially have a greater impact on health outcomes.
CMS is also seeking direction from the public and health care community on a variety of issues including care of persons with substance use disorders, same day services, and price transparency.
Finally, CMS recommends the 2019 PFS conversion factor be $36.05, which would be a slight increase above the 2018 PFS conversion factor of $35.99.
To find out more details about the proposed rule, review the summary from the American Medical Association, the CMS news release, and/or download the entire Rule from the Federal Register.