CMS Proposed Physician Fee Schedule for CY 2019

PUBLISHED: Jul 20, 2018
Relevant to: Ambulatory Care, Critical Access Hospitals, Hospitals, Medical Office

The U.S. Centers for Medicare and Medicaid Services (CMS) has issued proposed Physician Fee Schedule Rule for CY2019. In this proposed rule, CMS is proposing a number of coding and payment changes to reduce administrative burden and improve payment accuracy for E/M visits.

Some of the proposals include:

  • Allowing practitioners to choose to document office/outpatient E/M visits using medical decision-making or time instead of applying the current 1995 or 1997 E/M documentation guidelines, or alternatively practitioners could continue using the current framework;
  • Expanding current options by allowing practitioners to use time as the governing factor in selecting visit level and documenting the E/M visit, regardless of whether counseling or care coordination dominate the visit;
  • Expanding current options regarding the documentation of history and exam, to allow practitioners to focus their documentation on what has changed since the last visit or on pertinent items that have not changed, rather than re-documenting information, provided they review and update the previous information; and
  • Allow practitioners to simply review and verify certain information in the medical record that is entered by ancillary staff or the beneficiary, rather than re-entering it.

CMS is also proposing to pay separately for two newly defined physicians’ services furnished using communication technology:

  • Brief Communication Technology-based Service, e.g. Virtual Check-in (HCPCS code GVCI1)
  • Remote Evaluation of Recorded Video and/or Images Submitted by the Patient (HCPCS code GRAS1)

Follow the link below to review the proposed rule and for comment submission instructions.

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