tci Medicare Compliance & Reimbursement - 2014 Issue 23
Outpatient Outlook: Tune In to Key Changes Listed in 2015 Medicare Physician Fee Schedule
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Article Overview
This article reviews selected changes in the 2015 Medicare Physician Fee Schedule and explains why they matter for outpatient practices, medical groups, and other providers that bill Medicare. It covers payment policy timing, quality reporting expectations under PQRS, the accelerated rollout of the value modifier, and the addition of a new Medicare-reimbursable chronic care management service under CPT. The discussion is aimed at readers who want a high-level view of regulatory and coding updates tied to Medicare outpatient reimbursement.
Why This Topic Matters
These changes affect how outpatient organizations report quality data, prepare for payment adjustments, and structure care management services for Medicare patients. The article is relevant for practices assessing compliance readiness, billing workflows, and operational infrastructure for new reimbursement opportunities.
Article Sections
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Medicare payment outlook and SGR-related updates
Discusses the 2015 Medicare Physician Fee Schedule context, including payment update timing and the broader physician payment environment. It frames the policy changes that could affect Medicare reimbursement in the coming year.
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PQRS and value modifier changes
Summarizes the quality reporting requirements highlighted for 2015 and the planned progression of the value modifier. The section focuses on reporting and policy implementation developments for eligible professionals.
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Chronic care management reimbursement
Describes the new Medicare-reimbursable chronic care management service and related operational considerations. It also notes the article’s discussion of how the change fits into broader care management and payment policy trends.
What You Will Learn
- How the 2015 Medicare Physician Fee Schedule is affecting outpatient reimbursement policy
- What the article highlights about quality reporting and the value modifier
- What changed regarding Medicare reimbursement for chronic care management services
- Which organizations and policy issues are shaping the discussion around these updates
Who Should Read This
- Medical coders
- Outpatient billing staff
- Practice administrators
- Physician groups
- Compliance professionals
- Revenue cycle teams
Codes Discussed
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