Medicare Physician Payment Changes in 2016 (February 2016)

Why This Topic Matters

The article helps readers understand how 2016 Medicare physician payment policy affected reimbursement, reporting obligations, and practice operations. It also situates coding and valuation changes within broader CMS program updates so stakeholders can assess relevance to physician billing and compliance workflows.

Article Sections

1. SGR Repealed and Conversion Factor for 2016

   Explains the legislative and CMS context for the 2016 physician fee schedule update and the resulting conversion factor changes.

2. Target for Relative Value Adjustments for Misvalued Services

   Summarizes the policy framework for redistributing expenditures related to misvalued services and how CMS applied it for the year.

3. Twenty-fifth Anniversary of Medicare RBRVS

   Reviews longstanding relative value update activity and the role of specialty society recommendations in physician payment development.

4. Advanced Care Planning Services

   Describes the addition of advance care planning as a Medicare-covered service and the related CPT code updates discussed by CMS.

5. Lower Gastrointestinal Endoscopy Services

   Covers CMS finalization of revised coding and valuation for a group of lower gastrointestinal endoscopy services.

6. Radiation Therapy

   Discusses CMS action on radiation treatment delivery coding and the related equipment utilization assumptions used in payment calculations.

7. Potentially Misvalued Services

   Addresses CMS and RUC efforts to identify services for further review and update through valuation processes.

8. Incentive Payments to Primary Care Practitioners for Primary Care Services

   Summarizes the status of Medicare incentive payments for primary care practitioners and the end of a temporary bonus period.

9. Significant RVU Reductions Phase-In

   Explains CMS rules for phasing in certain large year-to-year relative value reductions for existing services.

10. Geographic Practice Cost Index (GPCI)

    Reviews geographic payment adjustments and statutory floor policies affecting physician practice cost indices.

11. Global Surgery

    Describes federal restrictions and data collection planning related to global surgery valuation policy.

12. Physician Quality Reporting System (PQRS)

    Summarizes 2016 reporting requirements and the resulting payment adjustment framework under PQRS.

13. Value-Based Payment Modifier (VM)

    Covers CMS implementation details for the value-based payment modifier and related performance assessment issues.

14. Physician Compare

    Discusses public reporting updates on the CMS Physician Compare website and the types of information being added.

15. Physician Services In Off-Campus Provider-Based Departments

    Introduces Medicare place-of-service updates for off-campus and on-campus outpatient hospital settings.