Changes to the Medicare Physician Fee Schedule: Good news?
This time, it's good news from the Centers for Medicare & Medicaid Services (CMS). Late last month, CMS announced proposed changes to the Medicare Physician Fee Schedule (MPFS) that would increase reimbursement for "evaluation and management" services, or the time you spend with patients advising them about their condition.
This represents significant increases for many athenahealth clients, particularly Primary Care and Internal Medicine providers. As CMS says, "For example, the work component for relative value units (RVUs) associated with an intermediate office visit, the most commonly billed physician's service, will increase by 37 percent." See the table below for other proposed changes.
Sample changes in outpatient office visit work RVUs
| CPT/HCPCS Code | 2005 Work RVU | Proposed Work RVU | Percent change |
|---|---|---|---|
| 99211 | 0.17 | 0.17 | 0 |
| 99212 | 0.45 | 0.45 | 0 |
| 99213 | 0.67 | 0.92 | +37 |
| 99214 | 1.10 | 1.42 | +29 |
| 99215 | 1.77 | 2.00 | +13 |
These are the largest revisions ever proposed for services related to patient evaluation and management. (The changes reflect the recommendations of the Relative Value Update Committee of the American Medical Association.) CMS hopes the changes will provide better financial support for physicians helping Medicare patients manage illnesses, and ultimately improve outcomes.
More specifically, the proposed changes involve: 1) conducting a comprehensive review of physician work RVUs, as well as 2) a new way to calculate practice expense RVUs, which would be phased in over four years.
CMS will respond to public comments on both sets of proposals and announce final policies in a final rule to be issued in early November. The changes would apply to payments for services to Medicare beneficiaries beginning in 2007.
For more information, please see the CMS press release.