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Proposed 2020 Medicare Physician Fee Schedule and Quality Payment Program

Proposed 2020 Medicare Physician Fee Schedule and Quality Payment Program

Proposed 2020 Medicare Physician Fee Schedule and Quality Payment Program

On July 29, 2019, the Centers for Medicare & Medicaid Services released their proposed 2020 Medicare Physician Fee Schedule and Quality Payment Plan. The proposal is over 1,000 pages long, but very few doctors have time to read the complete proposal. Here are some highlights that are worth noting about the project. The changes are proposed to create an innovative, affordable quality health care program with better accessibility.  

Physician Payment

Physician payments would go up to $36.09 under the CMS proposed plan. The plan proposes accepting those evaluation-and-management-coding changes recommended by the CPT Editorial Panel of the American Medical Association. In particular, there would still be five different billing levels for established patients, but there would be only four coding levels for new patients. A physician would be required to do a medical history and exam only where they felt it would be medically appropriate. Physicians could also choose the right level based on time spent or the medical-decision making process. These changes are likely to see physicians earning up to 12 % more in 2021.  

QPP's Merit-based Incentive Payment System

The proposed rule changes would allow physicians to report a smaller set of outcome-based measurements that apply to their specialty. The proposed changes would more closely align with alternative payment models. Doctors would need to meet a higher threshold to avoid negative payment penalties. To qualify for exceptional performance, physicians would need 80 points. The weight of the cost-performance category grows to 20 % while the quality performance category shrinks to 40 %.  

Opioid Treatment Changes

Doctors could charge a bundled fee for encouraging patients to get involved in an opioid treatment plan. This plan would need to include single and group therapy, pain management, and care coordination. Telehealth is an option to provide these services.

Supervision of Physician Assistants

Under the proposed changes, physician assistants would receive more power to act independently, unless state or local laws prevent it. It would be up to the supervising doctor and the physician assistant to create their agreement. Then, people could follow the agreement as long as it is in writing.

Health care providers and the public have until September 29, 2019, to make comments on the proposed changes. Then, the government will make final changes to the plan. Once finalized, the new policy would take effect in January 2020. With so many proposed changes, it is vital to work with a medical billing service which is prepared to stay up-to-date on the plan's final details. You need to be working with a medical billing service which is committed to getting up to speed quickly so that you can get maximum dollar without any downtime. Contact Signature RCM to be your medical billing service. You can trust them to be aware of any changes in the law affecting your billing services.