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CMS issues final physician payment rule for 2019

The Centers for Medicaid and Medicare Services (CMS) issued its annual update to the Medicare Physician Fee Schedule


The CMS issued a final rule regarding the Physician Fee Schedule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019. Below you can review a few of the key points and access the full fact sheet from CMS:

Physician payment rates and coding and payment changes

The 2019 physician fee schedule conversion factor is $36.04, which is up from $35.99 this year and reflects a budget-neutrality adjustment required by law. CMS finalized several coding and payment changes aimed at reducing administrative burden and improving payment accuracy for evaluation and management visits. For 2021 and beyond, CMS will consolidate the payment rate for E/M visit levels 2 through 4 while maintaining the payment rate from E/M visit level 5, which is the highest-paying code.

Telehealth services

CMS will pay physicians for their time when they check in with Medicare beneficiaries via telephone or another telecommunications device. Physicians will also be paid for the time it takes to review a video or image sent by a patient to assess whether a visit is needed.

Merit-based Incentive Payment System

For 2019, CMS is adding eight MIPS quality measures, including four based on patients’ reporting of their outcomes. CMS is removing 26 quality measures. After receiving concerns from clinicians who were not eligible to participate in the MIPS program during the first two years, CMS is expanding the program. CMS is also finalizing an opt-in policy that allows some clinicians who otherwise would have been excluded under the low-volume threshold the option to participate in MIPS.

You may access the full fact sheet regarding the Physician Fee Schedule by clicking HERE 

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posted by OBarros
posted in CMS Announcement,Healthcare Management
posted date Nov 2018