General Surgery Coding Alert - 2014 Issue 1
Reimbursement: January Will Bring a 24.4 Percent Pay Cut Unless Congress Steps In
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Article Overview
This article reviews a proposed Medicare Physician Fee Schedule update and its expected impact on physician payment levels, selected specialties, and independent laboratories. It also explains CMS’s planned chronic care management initiative for patients with multiple chronic conditions, including the general framework for new service categories, patient consent, care coordination, and the roles of physicians and non-physician practitioners. The piece is relevant to practices tracking reimbursement policy, fee schedule changes, and emerging Medicare care management guidance.
Why This Topic Matters
It helps practices understand the direction of Medicare reimbursement policy, identify which provider groups may be affected, and prepare for possible future chronic care management requirements.
Article Sections
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Prepare for a Conversion Factor Plunge
Discusses the proposed Medicare Physician Fee Schedule and the anticipated broad payment impact for the coming year. It frames the fee schedule update in the context of the Sustainable Growth Rate and the pending final rule.
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Steeper Cuts Could Hit Some Specialties
Summarizes the article’s discussion of provider groups and practice types expected to see different projected payment effects under the proposal. It also notes how the impact is characterized within the Medicare payment framework.
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Hope for Chronic Care Management Fees in 2015
Covers CMS’s planned chronic care management proposal for a future calendar year. The section addresses the general structure of the new service concept, patient eligibility themes, consent and documentation considerations, and intended care coordination features.
What You Will Learn
- How the proposed Medicare Physician Fee Schedule is expected to affect reimbursement levels
- Which provider groups are discussed as potentially seeing different payment impacts
- What CMS is proposing for future chronic care management payment structure
- How the article frames patient consent and documentation as part of the proposed care management model
- Which broad types of practitioners may be involved in the proposed chronic care services
Who Should Read This
- Physicians
- Medical practice managers
- Billing and coding professionals
- Compliance staff
- Healthcare administrators
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