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CMS floats multiple E/M documentation options to supplement current guidelines

07/23/2018

The 20-plus-year reign of the current E/M documentation guidelines may be coming to an end, as CMS seeks to promote distinct elements of an office encounter, including medical decision-making or time, into more prominent positions, according to the proposed 2019 Medicare physician fee schedule.

Single-fee E/M pay rates poised to take over for new, established encounters

07/23/2018

by: Richard Scott and Julia Kyles

CMS is proposing to flatten payments for office encounters, suggesting a single payment rate of $93 for established office codes 99212-99215 and $135 for new patient codes 99202-99205 instead of distinct rates for each service, according to the proposed 2019 Medicare physician fee schedule.

QPP in the PFS 2019: More patient, outcome focus; ‘gold’ quality measures; other changes

07/23/2018

by: Roy Edroso

CMS shows it means business about outcome and patient-reported measures in the Quality Payment Program (QPP) and the merit-based incentive payment system (MIPS) section of the proposed 2019 Medicare physician fee schedule with measure changes that increase the focus in those areas. Other meaningful changes include a stripped-down, information-exchange-focused Promoting Interoperability category; new standards for small practices and low-volume exemptions; a proposed “tiered” quality scoring system; and more.

CMS proposes multi-service reduction for office procedures, E/Ms

07/23/2018

by: Laura Evans

Clinicians could see a cut to their Medicare reimbursement next year when an E/M visit is reported the same day as an office procedure.

Proposed rule provides an early look at next year’s coding changes

07/23/2018

by: Julia Kyles

You can expect 81 new codes, 27 deleted codes and more than a dozen revised CPT codes and HCPCS codes in 2019, according to the proposed 2019 Medicare physician fee schedule. In addition, CMS intends to shift the status of four E/M codes from bundled to active.

Proposed fee schedule round-up: Payment, policy, coding changes

07/23/2018

by: PBN Staff

Part B News staff combed the 1,473 pages of the proposed 2019 Medicare physician fee schedule to bring you complete coverage of the changes that could affect your practice.

Single-rate E/M pay structure creates winners, losers under proposed fee schedule

07/23/2018

by: Richard Scott

Some specialties, including podiatry and dermatology, would see a significant pay increase for E/M services should CMS’ proposal to group level 2 through 5 outpatient codes into one payment basket go into effect on Jan. 1, according to a reimbursement estimates contained in the proposed 2019 Medicare physician fee schedule released July 12.

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