2016 Medicare physician fee schedule released

by Part B News staff on Oct 30, 2015
Practices have a new revenue opportunity in 2016 for providing advance care planning (ACP) services, as finalized in the final 2016 Medicare physician fee schedule released Oct. 30.
 
CMS kept all the attributes of this new payable service for discussion of end-of-life issues described in the proposed rule: one 30-minute code (99497) and one add-on 30-minute code (99498), not limited to particular physician specialties nor to a particular place of service. CMS noted work relative value units of 1.50 (99497) and 1.40 (99498) that, when combined with the other pieces of RVUs due out soon and the conversion factor, will reveal the payments for the services.
 
Other provisions upon the Part B News team's initial review:
  • Incident-to services: Only the physician or practitioner who directly supervises incident-to services may bill for those services under provisions in the final rule. The supervising physician need not be the provider who ordered or initiated the care, CMS clarified.
  • Conversion factor: The conversion factor will take a hit in 2016, as it’s set to drop to $35.8279 from the current rate of $35.9335.
  • PQRS and value-based modifier: Practices with at least one physician, nurse practitioner, physician assistant, certified registered nurse anesthetist or certified nurse specialist on staff will face the value-based modifier and the physician quality reporting system (PQRS) pay cuts based on their physician quality reporting efforts.
Stay tuned to Part B News for a complete breakdown of the final rule.
 
Short on time? Get a complete breakdown of the rule in just 60 minutes during the webinar 2016 Physician Fee Schedule Final Rule – Prepare now for incident-to, advance care planning, revenue changes in 2016 on Nov. 19. Learn more at http://www.decisionhealth.com/conferences/A2619.
 
Blog Tags: CMS, conversion factor, fee schedule
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