decisionhealth Newsletters, Part B News - 2012 Issue 11 (November)
Physician fee schedule: Payment modifier applies only to large groups in 2015
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Article Overview
This article summarizes CMS guidance in the final 2013 Medicare physician fee schedule on when the value-based payment modifier begins to affect physician payments and how the phase-in differs for larger and smaller practices. It is relevant to physicians, group practices, compliance and revenue cycle staff, and coders who follow Medicare payment policy, quality reporting, and health information reporting requirements. The article also places the policy in the context of physician quality reporting system measures, meaningful use, and broader payment reform.
Why This Topic Matters
Payment policy timing and group-size thresholds can affect future Medicare reimbursement and reporting priorities for physician practices. Understanding the phase-in helps organizations prepare for quality reporting and payment adjustments under CMS rules.
What You Will Learn
- How CMS structured the phase-in of a Medicare physician payment modifier
- Which types of practices are affected first under the policy discussed
- How the article relates the modifier to quality reporting and electronic health record reporting
- Why practice size matters under the CMS payment approach described
- How this policy fits into broader Medicare payment reform
Who Should Read This
- Physicians
- Medical group administrators
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle professionals
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