decisionhealth Newsletters, Part B News - 2026 Issue 7 (July)
CMS plans to replace G2211, change pay structure
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Article Overview
This article reviews a proposed change in the 2027 Medicare physician fee schedule involving office/outpatient and home or residence evaluation and management services. It covers the proposed payment approach, a separate consideration for clinicians participating in accountable care organizations, and a request for public comment about services performed on the same day as procedures with a global period.
Why This Topic Matters
The proposal may affect how clinicians and billing teams assess changes to Medicare payment and reporting processes for evaluation and management services.
Article Sections
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CMS floats 2 new modifiers, descriptors and payments
This section discusses CMS's proposed approach to visit complexity and payment for clinicians inside and outside accountable care organizations. It also covers the agency's request for comments on services performed on the same day as procedures with a global period.
What You Will Learn
- What CMS proposes to change in its treatment of visit complexity for evaluation and management services.
- How the proposal addresses clinicians participating in accountable care organizations.
- What payment structure and same-day procedure topics are included in the proposal.
- intended_audiences: [
- Medical coders and billers
- Clinicians who provide evaluation and management services
- Medicare reimbursement and practice-management professionals
- Clinicians and organizations participating in accountable care organizations
Who Should Read This
- Medical coders and billers
- Clinicians who provide evaluation and management services
- Medicare reimbursement and practice-management professionals
- Clinicians and organizations participating in accountable care organizations
Codes Discussed
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