Higher E/M pay to be proposed, backed by CMS

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers CMS and AMA RUC activity around proposed Medicare payment changes, with emphasis on evaluation and management reimbursement, quality reporting programs, and related physician payment policy discussions. It also touches on the sustainable growth rate formula, pay-for-performance concepts, and efforts to make payment information more transparent. The piece is aimed at physicians, coders, practice managers, and other healthcare stakeholders tracking reimbursement policy and federal payment updates.

Why This Topic Matters

It helps readers understand pending federal payment policy changes that may affect physician reimbursement, quality reporting expectations, and Medicare administrative processes.

Article Sections

  1. CMS support for proposed E/M payment increases

    Discusses CMS backing for proposed changes to physician work RVUs and broader payment updates under the RUC review process. Covers the policy context and rulemaking status at a high level.

  2. Time to look at SGR, P4P

    Reviews CMS interest in reforming Medicare payment methodology and linking reimbursement concepts to quality reporting. Also addresses quality measure development, the Provider Voluntary Reporting Program, and gainsharing discussions.

  3. Patients to gain access to payment amounts

    Summarizes plans to publicize Medicare payment amounts for common services and notes possible inclusion of private payer data.

  4. Congressman: Permanent pay fix a hard sell in election year

    Covers congressional commentary on prospects for temporary versus permanent Medicare payment fixes and broader political discussion of the payment update formula.

What You Will Learn

  • The policy context behind proposed Medicare physician payment changes
  • How CMS and AMA RUC activities relate to payment update rulemaking
  • The general role of quality reporting in physician payment initiatives
  • Why Medicare payment formula reform is part of the discussion
  • What types of payment transparency initiatives are being discussed

Who Should Read This

  • Physicians
  • Medical coders
  • Billing staff
  • Practice managers
  • Health policy professionals
  • Healthcare administrators

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