decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 8 (August)
Stricter incident-to rules CMS proposes could mean less revenue for practices
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Article Overview
This article reviews proposed 2016 Medicare physician fee schedule changes from CMS that could affect practice revenue and compliance. It covers incident-to billing policy, new payment considerations for advance care planning, updates to conversion factors, and proposed changes to PQRS and the early structure of MIPS. The piece is relevant to physicians, non-physician practitioners, practice managers, and billing/coding professionals tracking Medicare policy and reporting requirements.
Why This Topic Matters
The proposal may change how practices bill for services furnished by non-physician practitioners, how quality reporting evolves, and how Medicare payment updates are calculated. Readers who manage reimbursement, compliance, or reporting may need to understand the scope of the proposed changes and comments CMS is seeking.
Article Sections
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Incident-to billing proposal
Discusses CMS’s proposed revision to incident-to supervision requirements and the broader compliance and reimbursement implications for practices and non-physician practitioners.
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New payment for advanced care planning
Summarizes proposed Medicare payment coverage considerations for advance care planning services and related valuation and coverage context.
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Conversion factor not affected by SGR
Covers the proposed 2016 Medicare physician fee schedule conversion factor and anesthesia conversion factor updates in the context of recent statutory changes.
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CMS makes changes to PQRS
Outlines proposed changes to quality reporting programs, including PQRS updates and the emerging MIPS framework.
What You Will Learn
- How CMS proposed to change incident-to supervision policy
- What the article says about proposed payment for advance care planning
- How the 2016 Medicare fee schedule update is framed in relation to conversion factors
- What program changes were proposed for PQRS and the early MIPS structure
- Which provider groups are discussed in connection with the proposed quality modifier approach
Who Should Read This
- Physicians
- Non-physician practitioners
- Medical practice managers
- Medical coders
- Billing and reimbursement staff
- Compliance professionals
Codes Discussed
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