decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 7 (July)
Proposed fee schedule: Practitioners would see 24.4% pay cut, new chronic care management services
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Article Overview
This article reviews proposed 2014 Medicare physician fee schedule changes and explains how they could affect practitioner reimbursement and coverage policy. It is aimed at physicians, coders, revenue cycle staff, and compliance professionals who track Medicare payment updates, telehealth policy, chronic care management, and preventive screening rules. The discussion covers the projected fee schedule impact, new non-face-to-face care management services, transitional care management and telehealth updates, and screening-related coverage changes.
Why This Topic Matters
The proposed changes could affect Medicare payment levels, service availability, and documentation or billing workflows for common outpatient and preventive services. Readers who bill Medicare or manage coding compliance need to understand the scope of the update and which services are being added or revised.
Article Sections
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Proposed Medicare physician fee schedule impact
This section discusses the proposed Medicare payment update and its potential effect on overall physician reimbursement. It also introduces how the change may vary by service type.
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Examples of affected services
This section gives examples of common office and procedure services discussed in the context of the proposed fee schedule. It illustrates the kinds of services that could be affected by the update.
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New chronic care management services
This section summarizes proposed new Medicare services related to non-face-to-face chronic care management. It frames the policy change in terms of primary care support and care coordination.
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Telehealth and transitional care management
This section covers proposed changes affecting telehealth inclusion and transitional care management services. It addresses how these services would be treated under the Medicare telehealth list.
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Screening test coverage expansions
This section reviews proposed coverage changes for preventive screening services. It focuses on access and ordering requirements for specific screening tests.
What You Will Learn
- How the proposed Medicare physician fee schedule could affect physician reimbursement
- What categories of new care management services are being proposed
- Which service groups are being considered for telehealth inclusion
- What preventive screening coverage changes are being proposed
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance professionals
- Primary care practices
Codes Discussed
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