decisionhealth Newsletters, Part B News - 2018 Issue 7 (July)
MedPAC: Give E/M services a big raise and cut procedure, surgical payments
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Article Overview
This article reviews MedPAC’s latest recommendations to CMS on physician payment policy, with emphasis on payment shifts affecting outpatient evaluation and management services, procedures, and surgical services. It is relevant to coders, billers, physicians, consultants, and practice leaders who track Medicare reimbursement trends and the broader valuation of medical services. The discussion also covers the Commission’s concerns about data used to value services, global surgical payment assumptions, and the potential impact on different specialties.
Why This Topic Matters
The article explains a proposed Medicare payment realignment that could materially affect reimbursement patterns across specialties and service types. It helps readers understand the policy and valuation issues that may influence future coding and payment updates.
Article Sections
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Physician payments
Overview of MedPAC’s physician payment recommendations and the broad categories of services expected to be affected. The section frames the policy discussion around Medicare reimbursement changes for office-based services, procedures, and surgical care.
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Report targets misvalued services
Discussion of MedPAC’s concerns about service valuation methodology and the data CMS uses to assign relative values. The section also addresses broader payment issues tied to testing services and surgical package assumptions.
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Shifting payment structures spur change
Exploration of how recent CMS payment initiatives fit into a move toward episodic and care-coordination-oriented reimbursement. The section considers possible implications for future policy direction and specialty impact.
What You Will Learn
- How MedPAC is framing its recommendations on Medicare physician payment changes
- What broad service categories are being discussed in relation to reimbursement shifts
- Why CMS valuation methodology and service-time assumptions are part of the debate
- How global surgical payment assumptions fit into current policy review
- What types of specialties may be affected by proposed payment realignment
Who Should Read This
- Medical coders
- Physician billers
- Revenue cycle professionals
- Practice managers
- Physicians
- Healthcare consultants
- Policy analysts
Codes Discussed
Code Ranges Discussed
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