CMS proposes changes to Medicare Physician Fee Schedule for CY 2020
The Centers for Medicare & Medicaid Services late today issued a proposed rule that would update physician fee schedule rates by 0.14% in calendar year 2020.
CMS also proposes changes for evaluation and management (E/M) services. Specifically, it would revert back to setting separate payment rates for all five levels of E/M visits rather than blending payment rates for certain levels (as it finalized last year). Also building on changes in last year’s PFS rule related to teaching physician documentation, CMS now proposes to allow physicians and certain non-physician practitioners to review and verify, rather than re-document, notes made in the medical record by other members of the medical team.
In addition, the rule includes several proposals related to care management services, including to increase payment and billing flexibility for care management provided to beneficiaries after discharge from inpatient and certain outpatient stays. CMS also proposes changes to improve the accuracy of payment for chronic care management services and reduce burden associated with billing for these services, and to introduce new coding and payment for care management services for patients with a single serious chronic condition.
CMS proposes updates to the Merit-based Incentive Payment System for the CY 2020 reporting period, including a higher weight on cost measures, and higher performance standards for earning positive payment adjustments. For CY 2021 reporting, CMS proposes to begin implementing the new MIPS Value Pathways that, over time, the agency believes would reduce and align reporting requirements across the four MIPS performance categories.
The proposed rule also contains several provisions related to treatment of opioid use disorder. These include provisions to implement the new statutorily required Medicare Part B benefit for OUD treatment services by Jan. 1, 2020; a new monthly bundled payment for management and counseling for OUD; and the addition of three new codes describing a bundled episode for OUD treatment to the approved list of telehealth services.
CMS will accept comments on the proposed rule through Sept. 27.