November 07, 2019

CMS Publishes Physician Fee Schedule and Quality Payment Program Final Rule

With simplifications to billing requirements, streamlined requirements under the improved Quality Payment Program, and increased payments for chronic care management services, CMS will allow “clinicians to spend more time delivering high quality care for patients.” These updates, which start January 1, 2021, were implemented in response to an Executive Order directing CMS “to enable providers to spend more time with patients.” The rule simplifies billing coding requirements that are over two decades old. Furthermore, CMS is “increasing payment for office and outpatient E/M visits as well as providing enhanced certain types of visits” as recognition for the increased time clinicians spend treating their patients. Second, CMS added a new code that pays physicians for time spent managing the care of patients with single, high-risk chronic conditions, increasing payments to practitioners providing transitional care to patients leaving hospital care, and paying practitioners more if they spend more time on chronic care management services for patients with multiple chronic conditions. Finally, CMS is simplifying the Merit-based Incentive Payment System by providing a new framework that holds clinicians “accountable for fewer but more meaningful measures.”