decisionhealth Newsletters, Coder Pink Sheets - 2019 Issue 10 (October)
Proposed physician fee schedule: Defining the newly proposed ‘principal’ care management
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Article Overview
This article explains a proposed CMS payment policy update focused on care management for patients with a single serious chronic condition. It is relevant to physicians, qualified health care professionals, care management staff, and billing/coding professionals who need to understand the scope of the proposed service, the type of patient complexity involved, and the broader reporting and reimbursement context.
Why This Topic Matters
The proposal affects how practices may document and bill for a specialized care management service under CMS policy. Understanding the proposed framework helps organizations evaluate workflow, compliance, and revenue implications for high-risk chronic care management.
What You Will Learn
- The policy context for CMS’s proposed principal care management service
- How the proposal frames patient complexity and care management involvement
- What types of clinical and administrative stakeholders may be affected by the change
- The general reimbursement context associated with the proposed service
Who Should Read This
- Physicians
- Qualified health care professionals
- Care management staff
- Medical coders
- Billing staff
- Practice administrators
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