decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 10 (October)
Payment fluctuations create big winners, losers among most-billed services
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Article Overview
This article reviews a Coding Pro analysis of CMS’s proposed 2020 Medicare physician fee schedule, focusing on high-volume services and the payment changes projected to affect them most. It is useful for coders, billers, physicians, and practice managers who monitor Medicare payment updates, especially in radiology, cardiology, ophthalmology, injection services, chronic care management, and transitional care management. The article also summarizes related CMS and AMA/RBRVS context and notes where the proposed rule placed particular attention on specific services and payment categories.
Why This Topic Matters
Proposed physician fee schedule changes can affect workflow, service volume, and revenue across multiple specialties. Understanding which high-volume services are projected to move up or down helps practices prioritize review of Medicare reimbursement trends.
Article Sections
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Analysis of high-volume services in the proposed 2020 fee schedule
Introduces the CMS proposed 2020 Medicare physician fee schedule analysis and explains that the focus is on frequently billed services with large projected payment changes.
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Projected increases among common services
Summarizes categories of services that were projected to receive payment increases, including imaging, cardiology-related services, and certain dermatologic procedures.
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Assessing the losses
Reviews service categories projected to receive payment reductions and notes the broader context for changes affecting some care management and imaging services.
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Evaluating E/M rate changes
Discusses the limited movement expected among common evaluation and management services and highlights the transitional care management services receiving special attention.
What You Will Learn
- How the article frames the proposed 2020 Medicare payment changes for high-volume services
- Which broad specialties and service categories are highlighted as projected gainers or losers
- How CMS’s proposed rule discussion relates to common imaging, cardiology, eye care, injection, and care management services
- Why transitional care management services received special attention in the proposed updates
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Physician practices
- Specialty groups
- Practice managers
- Compliance teams
Codes Discussed
Modifiers Discussed
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