decisionhealth Newsletters, Part B News - 2022 Issue 4 (April)
CMS’ revamped split/shared policy could jeopardize physician payments
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Article Overview
This article explains how CMS’s revised Medicare split/shared policy may affect compensation in physician practices, especially arrangements tied to work relative value units and shared visit billing. It also covers reactions from medical societies, concerns about care-team workflows, and practical considerations for organizations evaluating compensation model changes. The piece is aimed at coders, practice managers, compliance staff, and physician leaders following Medicare reimbursement policy.
Why This Topic Matters
Changes to split/shared billing can influence both compliance workflows and physician pay structures, so organizations that use shared E/M services need to understand the policy shift and its operational impact.
Article Sections
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Policy impact on compensation and billing
Introduces the Medicare split/shared policy change and its potential effects on reimbursement, compensation models, and practice operations.
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Hidden within the policy
Discusses compliance focus, transition-year considerations, and concerns raised by medical societies and care teams about the broader effects of the rule.
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What to do before you change models
Outlines high-level considerations for practices reviewing compensation structures, workflows, and team composition in response to the policy change.
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Resources
Lists external references and supporting materials cited by the article.
What You Will Learn
- How a Medicare split/shared policy change can affect practice compensation structures
- Why shared visit workflow and care-team composition may need review
- What types of organizational planning are relevant when compensation models are reassessed
- How professional societies are responding to the policy shift
Who Should Read This
- Medical coders
- Compliance officers
- Practice managers
- Physician leaders
- Revenue cycle professionals
- Healthcare consultants
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