Proposed fee schedule continues emphasis on quality care payments

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains how the 2009 proposed Medicare physician fee schedule was shaping reimbursement policy and quality reporting requirements. It is relevant to ophthalmology practices, coders, and compliance staff who track CMS payment policy, Relative Value Scale Update Committee review activity, and Physician Quality Reporting Initiative measures. The article also summarizes which broad ophthalmology services were identified for closer valuation review and highlights the proposed quality-reporting topics discussed for 2009.

Why This Topic Matters

The piece helps readers understand where CMS was focusing attention in the upcoming fee schedule cycle and how quality reporting incentives were evolving. It is useful for practices monitoring payment policy, measure participation, and areas of service growth that may draw review.

Article Sections

  1. Medicare fee schedule and valuation review

    This section discusses the proposed Medicare physician fee schedule for the following year and CMS review activity related to potentially misvalued services and supplies. It highlights the ophthalmology services identified for further review.

  2. Physician Quality Reporting Initiative (PQRI)

    This section covers proposed changes to PQRI, including expansion of the measure set and the addition of ophthalmology-related quality reporting topics. It also notes CMS activity related to incentive payments and reporting participation.

  3. Official resources

    This brief closing section points readers to external CMS and federal rule resources for additional information about the proposed policy updates and quality reporting program.

What You Will Learn

  • How the proposed Medicare physician fee schedule was changing for the upcoming year
  • What general kinds of ophthalmology services CMS identified for review
  • How PQRI was expected to expand and what broad ophthalmology quality topics were included
  • Where official CMS and federal rule resources for the proposal were located

Who Should Read This

  • Ophthalmology coders
  • Medical billing staff
  • Compliance professionals
  • Physician practice administrators
  • Quality reporting coordinators

Codes Discussed


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