E/M Coding Alert - 2005 Issue 28
REIMBURSEMENT: CMS Projects Steep Cut, But Johnson Proposes Increase Instead
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Article Overview
This premium article covers Medicare reimbursement developments affecting physicians and related services. It compares CMS’s projected physician payment cuts with a proposed alternative payment reform bill, and it summarizes additional fee schedule changes involving imaging, glaucoma screening, telehealth, drug payment policy, malpractice adjustments, and a quality-data demonstration program. The article is aimed at readers tracking Medicare payment policy, physician reimbursement, and federal health policy updates.
Why This Topic Matters
The piece explains policy changes that could affect physician payment updates and Medicare service coverage, making it relevant for practices, coders, compliance teams, and reimbursement professionals who monitor annual Medicare proposals and legislative alternatives.
Article Sections
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Physician payment cuts and legislative response
Covers CMS’s projected physician payment outlook and congressional efforts to modify the payment framework. The section also discusses related federal budget and administration-level policy action.
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Medicare fee schedule and coverage proposals
Summarizes proposed updates in the 2006 physician fee schedule affecting selected covered services and payment methodologies. Topics include screening coverage, imaging, telehealth, drug-related payment policy, and physician practice expense adjustments.
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Demonstration program comment request
Describes CMS’s request for input on continuing a demonstration focused on collecting patient symptom data in oncology care. The section addresses the program’s potential evolution and data collection goals.
What You Will Learn
- How CMS and Congress were addressing Medicare physician payment policy
- Which broad categories of physician fee schedule changes were proposed for 2006
- What types of Medicare service and payment policies CMS was revising or considering
- How a quality-data demonstration program in oncology was being evaluated for continuation
Who Should Read This
- Medical coders
- Reimbursement specialists
- Practice managers
- Compliance staff
- Health policy analysts
- Physician billing teams
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