E/M Coding Alert - 2017 Issue 12
Part B Reimbursement: Expect Reduced Burdens, Cutbacks, and Delays, MPFS Final Rule Suggests
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Article Overview
This article summarizes major CMS changes in the 2018 Medicare Physician Fee Schedule final rule. It covers broad payment-policy updates, telehealth expansion, diabetes prevention program changes, quality reporting and MIPS/PQRS alignment, MACRA-related initiatives, and payment adjustments affecting certain outpatient and off-campus services. It is relevant for clinicians, coders, billing staff, practice administrators, and healthcare organizations tracking Medicare Part B reimbursement and compliance updates.
Why This Topic Matters
The final rule affects how Medicare Part B services are reported, paid, and managed in 2018, including quality-reporting requirements, telehealth billing, chronic care and behavioral health integration, and outpatient payment changes. Understanding the scope of these updates helps practices anticipate operational and reimbursement impacts.
Article Sections
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Background and rule overview
Introduces the CMS Medicare Physician Fee Schedule final rule for calendar year 2018 and its focus on program updates, payment policies, delays, and implementation dates.
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Patients Over Paperwork initiative
Describes CMS efforts to reduce administrative burden and streamline reporting requirements as part of broader quality- and value-based care priorities.
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Telehealth expands with new code options
Summarizes telehealth-related updates, including newly finalized service options and the removal of a telehealth billing requirement.
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Other important MPFS updates
Covers additional Medicare Physician Fee Schedule changes, including diabetes prevention, evaluation and management documentation, quality reporting, MACRA-related initiatives, and payment adjustments.
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OPPS payment cut punishes providers
Explains the final rule’s payment reduction for certain non-excepted off-campus departments and its relationship to outpatient payment policy.
What You Will Learn
- What categories of Medicare Part B reimbursement policy changed in the 2018 final rule
- How CMS is approaching administrative burden reduction and reporting simplification
- Which telehealth and related billing topics were addressed
- What other Medicare quality, prevention, and MACRA-related updates were highlighted
- How the rule affects certain outpatient and off-campus payment policies
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Physicians and clinicians
- Healthcare compliance teams
- Hospital reimbursement professionals
Codes Discussed
Modifiers Discussed
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