decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 8 (August)
Proposed 2016 Medicare physician fee schedule: CMS’ incident-to plan: Bill under NPI of provider who supervises not initiates care
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Article Overview
This article explains selected provisions from CMS’ proposed 2016 Medicare physician fee schedule and how they may affect physician practices, non-physician practitioners, and compliance workflows. It covers incident-to billing supervision changes, the proposed handling of larger RVU reductions, updates tied to PQRS and the emerging MIPS framework, and new payment policy for advance care planning services. The piece is aimed at billing, coding, compliance, and practice management professionals who need to understand the scope of the proposed changes and their operational impact.
Why This Topic Matters
The proposed updates affect how practices report and bill services, manage quality program participation, and prepare for Medicare payment methodology changes. Understanding the scope of the proposal helps organizations evaluate compliance risk and anticipate workflow adjustments.
Article Sections
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Incident-to billing proposal
Discusses proposed changes to Medicare incident-to rules and the operational impact on practices that use auxiliary personnel and non-physician practitioners.
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Unequal phase-in of big RVU reductions
Summarizes proposed handling of larger relative value unit reductions and how phased implementation could apply across service components.
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CMS makes changes to PQRS
Reviews proposed updates to the Physician Quality Reporting System and the related transition toward the Merit-based Incentive Payment System.
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New payment for advance care planning
Introduces proposed payment policy for advance care planning services and identifies the related CPT coding area.
What You Will Learn
- How the proposed Medicare incident-to policy would affect billing supervision and practice workflows
- How CMS proposes to phase in larger RVU reductions under the fee schedule
- What changes are proposed for PQRS and the emerging MIPS quality framework
- How the article frames proposed Medicare payment for advance care planning services
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Physician group administrators
- Non-physician practitioners
Codes Discussed
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