decisionhealth Newsletters, Part B News - 2014 Issue 11 (November)
Physicians expect SGR fix to avoid 21% pay cut in April and more from 2015 rule
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Article Overview
This article reviews major elements of the final 2015 Medicare physician fee schedule and related Medicare policy updates. It is aimed at physicians, coders, and reimbursement staff who need to understand broad coverage of payment changes, telehealth additions, global surgery policy shifts, mammography updates, therapy cap issues, and shared-savings program measure changes. The article also places these updates in the context of the Sustainable Growth Rate situation and expected congressional action.
Why This Topic Matters
The article helps readers track Medicare payment policy changes that can affect reimbursement, practice operations, and compliance planning for the year ahead. It is especially relevant for practices that bill Medicare, provide telehealth services, perform screening colonoscopies, furnish therapy, or participate in shared-savings arrangements.
Article Sections
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Physician fee schedule round-up
Introduces the broader Medicare physician payment environment for 2015 and summarizes the context surrounding the fee schedule update.
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Other notable fee schedule provisions
Covers several separate Medicare payment and coverage policy changes affecting surgical global periods, preventive services, telehealth, mammography, rural and federally qualified health centers, locum tenens arrangements, therapy limits, and shared-savings program measures.
What You Will Learn
- How the 2015 Medicare physician fee schedule is framed by broader payment policy concerns
- Which categories of Medicare services received coverage or billing-related updates
- What types of practice areas are affected by telehealth, therapy, mammography, and shared-savings changes
- How CMS signaled future policy direction on bundled surgical services and other payment issues
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Reimbursement specialists
- Compliance teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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