decisionhealth Newsletters, Part B News - 2015 Issue 7 (July)
CMS proposes unequal phase-in of big RVU reductions over two years
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Article Overview
This article covers a CMS proposal in the Medicare physician fee schedule that would change how large RVU reductions are phased in over two years, along with related discussions of which services qualify for the phase-in and how different service components may be treated. It also outlines CMS’s ongoing misvalued-code review process, including public nominations and broader review categories that may affect physician payment policy. The piece is relevant to physician practices, coders, compliance staff, and anyone tracking Medicare valuation changes and proposed rulemaking.
Why This Topic Matters
The proposal could affect how quickly payment changes are felt when service values are reduced, and it may influence reimbursement planning across settings and service components. The article also flags multiple codes and review categories that may be subject to CMS scrutiny, making it useful for practices monitoring potential valuation impacts.
Article Sections
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Proposed phase-in of large RVU reductions
Explains the CMS proposal for spreading major RVU reductions across two years and discusses the rationale for the approach.
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Applies only to unchanged codes
Describes the scope of the phase-in proposal and the types of code changes CMS says would be excluded from it.
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Additional wrinkles to proposed plan
Covers how different service settings and service components may affect the phase-in approach under the proposal.
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Codes proposed as misvalued
Summarizes the misvalued-code review topics raised by commenters and CMS, including broader review categories and valuation concerns.
What You Will Learn
- How CMS proposes to phase in large reductions in RVU values over two years
- Which broad types of services and code changes may be excluded from the phase-in proposal
- How facility and non-facility settings may be treated differently under the proposal
- What CMS is reviewing in its misvalued-code process and broader RVU valuation initiatives
Who Should Read This
- Medical coders
- Physician practices
- Compliance staff
- Revenue cycle teams
- Healthcare policy analysts
- Payer relations staff
Codes Discussed
Code Ranges Discussed
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