decisionhealth Newsletters, Part B News - 2018 Issue 7 (July)
Suggested E/M pay hikes would create fee-schedule winners and losers
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Article Overview
This article reviews a Medicare Payment Advisory Commission (MedPAC) recommendation to increase outpatient evaluation and management (E/M) payments and describes how a budget-neutral fee-schedule adjustment could shift reimbursement across specialties. It is relevant for physicians, practice managers, coders, and reimbursement professionals who track Medicare policy, specialty payment impacts, and annual fee-schedule changes. The article focuses on the broad policy proposal, the expected distribution of winners and losers, and the Medicare context behind the analysis.
Why This Topic Matters
Changes to E/M reimbursement can materially affect specialty revenue, budgeting, and payer strategy. Understanding the direction and scale of the proposed fee-schedule impact helps organizations anticipate Medicare payment shifts and plan for downstream operational changes.
What You Will Learn
- What MedPAC recommended regarding outpatient E/M payment policy
- How budget neutrality can create offsetting changes for other services
- Which specialties were projected to see larger gains or reductions
- Why the proposal matters in the context of Medicare physician reimbursement
Who Should Read This
- Physicians
- Practice managers
- Medical coders
- Reimbursement specialists
- Healthcare administrators
- Revenue cycle professionals
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