decisionhealth Newsletters, Part B News - 2018 Issue 7 (July)
CMS proposes multi-service reduction for office procedures, E/Ms
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Article Overview
This article explains a proposed Medicare physician fee schedule policy that would reduce payment when office E/M visits and certain procedures are billed together, along with a separate proposal to lower the work value of selected office procedure codes. It is relevant to physicians, coders, billers, and reimbursement staff who follow CMS policy changes affecting office-based services and E/M reporting. The article also discusses industry reaction and examples of the types of services affected, without replacing the full premium analysis.
Why This Topic Matters
The proposal could affect reimbursement for common office encounters and procedure-based visits, making it important for practices that bill E/M services alongside procedures under Medicare.
Article Sections
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E/M payment changes
Introduces the proposed Medicare multiple-service adjustment for office E/M visits reported with procedures and discusses the policy rationale and stakeholder reaction.
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Certain office procedure values reduced
Covers CMS’s separate proposal to lower the work value for selected office procedure codes that are frequently billed with E/M services and compares proposed and current payment levels.
What You Will Learn
- The general direction of CMS’s proposed office-visit and procedure payment changes
- How the article frames the relationship between E/M services and procedure billing
- Which categories of office procedures are discussed as potentially affected
- How the proposal is positioned within broader Medicare physician fee schedule changes
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Practice managers
- Reimbursement specialists
- Compliance staff
Codes Discussed
Modifiers Discussed
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