decisionhealth Newsletters, Part B News - 2015 Issue 7 (July)
Get paid for more of providers’ ‘cognitive work’ with new E/M codes – in 2017
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Article Overview
This article covers Medicare’s proposed expansion of E/M payment policy to better recognize care coordination and other non-face-to-face provider work. It is relevant to physicians, practice managers, coders, and compliance staff tracking Medicare physician fee schedule updates, especially proposals tied to transitional care management, chronic care management, and broader value-based reimbursement trends. The article also summarizes the comment opportunity, the general structure Medicare is considering, and the anticipated timing of new codes.
Why This Topic Matters
It helps readers understand an upcoming Medicare payment policy shift that may affect how coordinated care activities are documented, reported, and reimbursed. It also provides context for practices preparing for broader changes in evaluation and management payment models.
Article Sections
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Medicare’s proposed care-coordination E/M changes
Introduces the proposed expansion of evaluation and management reimbursement and the general types of coordinated care activities under discussion. It frames the policy as part of Medicare’s broader physician fee schedule update.
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Examples of cognitive work and care coordination
Summarizes the broad categories of non-face-to-face and coordination-related work Medicare is considering. It discusses the kinds of activities being evaluated for future payment recognition.
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Structure, comments, and timing
Describes the proposed framework Medicare is considering for additional codes, including relationship and reporting context. It also notes the public comment process and the expected implementation timeframe.
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Prepare for the continued shift to value
Places the proposal in the context of Medicare’s ongoing movement away from traditional fee-for-service payment. It highlights the broader implications for practices and reimbursement planning.
What You Will Learn
- How Medicare is approaching future reimbursement for coordinated care activities
- What general kinds of provider work are being considered for new evaluation and management payment recognition
- How the proposal fits into broader Medicare physician fee schedule and value-based payment trends
- Why practices may want to monitor and comment on the forthcoming policy changes
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Health care administrators
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