decisionhealth Newsletters, Part B News - 2015 Issue 11 (November)
Conversion factor, policy changes and more from final 2016 fee schedule
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Article Overview
This article summarizes key provisions in the final 2016 Medicare Physician Fee Schedule. It covers fee schedule updates, quality reporting and meaningful use changes, therapy cap policies, telehealth updates, imaging and drug payment topics, rural and tribal facility provisions, and selected coding changes that affect physicians, hospitals, and other outpatient providers. It is relevant for practices that bill Medicare and for staff tracking annual policy updates from CMS.
Why This Topic Matters
The 2016 fee schedule affected payment, reporting, and billing workflows across multiple specialties and site-of-service settings. Readers can use this roundup to identify which CMS policy areas may affect their practice or coding operations.
Article Sections
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Fee schedule round-up
Introduces the overall scope of the final 2016 physician fee schedule and summarizes broad payment updates affecting Medicare providers.
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Quality reporting changes
Reviews changes affecting clinical quality reporting, meaningful use alignment, CPC reporting, and related Medicare quality programs.
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Policy changes
Covers CMS policy updates involving surgery global periods, therapy caps, telehealth, private contracting, imaging criteria, and related Medicare program adjustments.
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Payment changes
Summarizes payment-related updates for selected services, including imaging, drugs, facilities, and other Medicare billing topics.
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Coding changes
Highlights coding-related updates for radiation services, chronic care management, rural health centers, and federally qualified health centers.
What You Will Learn
- What major 2016 Medicare fee schedule areas were updated by CMS
- Which quality reporting programs were affected by the final rule
- Which broad policy areas changed for therapy, telehealth, imaging, and contracting
- Which service categories saw payment-related updates
- Which billing and reporting changes affected rural and community-based providers
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Physician practices
- Rural health centers
- Federally qualified health centers
- Quality reporting staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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