HCPro, JustCoding Outpatient - 2019 Issue 31 (July)
Healthcare News: CMS releases CY 2020 MPFS and OPPS proposed rules
July 30th, 2019
Subscribe or sign in to view the full article.
Article Overview
This article summarizes CMS’s 2020 proposed changes to the Medicare Physician Fee Schedule and the OPPS. It is relevant to coders, compliance staff, billing teams, and providers who track Medicare payment policy, E/M documentation updates, MIPS reporting, new CPT code additions, and outpatient drug and clinic payment changes. The discussion covers the broad scope of CMS’s proposed revisions, including physician services, hospital outpatient payment, and related Medicare policy areas.
Why This Topic Matters
These proposed rules can affect Medicare reimbursement, documentation expectations, reporting workflows, and how organizations prepare for upcoming payment and coding changes.
Article Sections
-
2020 MPFS proposed rule
Overview of the physician fee schedule proposal and the major policy areas CMS addresses for the coming year.
-
E/M payment and documentation proposals
Discussion of proposed changes affecting office evaluation and management payment structure, documentation expectations, and timing considerations.
-
CPT code updates
Summary of broad categories of newly added CPT content referenced in the proposed rule, including procedural and diagnostic areas.
-
MIPS policy changes
Coverage of CMS’s proposed adjustments to the quality reporting framework and its plan for a more streamlined structure.
-
2020 OPPS proposed rule
Overview of the outpatient prospective payment system proposal and the payment policy topics CMS addresses for hospitals and outpatient departments.
-
340B drug payments
Discussion of the proposed approach to outpatient drug payment policy and the response to legal developments affecting prior payment reductions.
-
CMS to complete clinic payment reduction phase-in
Summary of the proposed continuation of the outpatient clinic visit payment phase-in for off-campus provider-based departments.
What You Will Learn
- What CMS proposed for Medicare physician payment and outpatient payment systems in CY 2020
- Which broad areas of E/M documentation and reporting were addressed in the proposal
- How the article frames the proposed expansion of CPT content and reporting changes
- What CMS is seeking feedback on regarding MIPS modernization
- How the OPPS proposal addresses 340B drug payment policy and clinic visit payment adjustments
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Revenue cycle teams
- Physicians and practice managers
- Hospital outpatient coding staff
Codes Discussed
Code Ranges Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com