If you’re wondering whether you have a good chance of getting paid for the patient monitoring code 99091, newly unbundled in 2019, the current utilization and denial rates of other remote care codes give you some reason for optimism

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.

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.

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.

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.

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.

Physician burnout is a hot issue with a mountain of studies devoted to it. Health care organizations have begun to institute programs to relieve it, but some experts think you can make a big difference by simply making providers’ workflow more efficient, leaving them freer to practice medicine.