HCPro, JustCoding Outpatient - 2019 Issue 37 (September)
Payment fluctuations create big winners, losers among most-billed physician services
September 10th, 2019
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Article Overview
This article explains how proposed 2020 Medicare Physician Fee Schedule updates could affect reimbursement for frequently billed physician services. It focuses on broad payment trends affecting imaging, ophthalmology, cardiology, dermatology, injection, CT, and evaluation and management services, and it notes the specialties and service categories most likely to see changes. The piece is intended for coding, billing, and reimbursement professionals who monitor CMS payment policy and physician fee schedule updates.
Why This Topic Matters
The article helps readers understand which commonly billed services may see notable reimbursement shifts under the proposed Medicare fee schedule, so they can assess financial and operational impact at a high level. It is relevant for practices, coders, and revenue cycle teams tracking CMS policy changes.
Article Sections
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Overview of proposed 2020 payment changes
Introduces the scope of the Medicare Physician Fee Schedule proposal and identifies the broad service categories most affected by the update.
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Assessing the gains
Summarizes the service groups and specialties associated with projected reimbursement increases under the proposed payment update.
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Assessing the losses
Summarizes the service groups and specialties associated with projected reimbursement decreases under the proposed payment update.
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Evaluating E/M rate changes
Reviews the portion of the article focused on evaluation and management payment trends, including transitional care management and related policy context.
What You Will Learn
- How proposed Medicare fee schedule updates can affect common physician services
- Which broad specialty areas are discussed as potential payment winners and losers
- How the article frames reimbursement trends for imaging, procedural, and E/M services
- Why transitional care management services received special attention in the proposed rule
Who Should Read This
- Physician coders
- Medical billing staff
- Revenue cycle professionals
- Practice administrators
- Compliance teams
- Specialty practice managers
Codes Discussed
Modifiers Discussed
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