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You’ll find reason to cheer the expected payments for frequently reported codes in 2020 if you conduct a steady stream of transitional care management (TCM), X-rays and other services. You may be less enthused if your bread-and-butter encounters involve vision testing or CT scanning.

CMS believes that lots of work and low pay are making doctors avoid care management services, but it has a number of ideas designed to boost utilization.


Perhaps the biggest news impacting your participation in the Quality Payment Program (QPP) doesn’t have to do with 2020 (PBN 8/12/19). The Pathways (MVP) version of the Merit-based Incentive Payment System (MIPS) is slated to launch in 2021 and offers sufficiently meaningful changes that you may expect some transitional bumps that year.


If the codes CMS just cleared to be billed with transitional care management (TCM) in 2020 see a lift in utilization, you can be pretty confident that clearance will be the reason for the change. That's because, as you can see by this chart, utilization of these codes over the past five years has been very consistent — and mostly low — even when payment terms have been altered.


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