tci Medicare Compliance & Reimbursement - 2005 Issue 6
Physicians: Doctors Are Managing More Complex Patients, But E/M Payments Remain Stingy
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Article Overview
This piece covers a physician coalition’s argument that Medicare evaluation and management payment policy is outdated relative to modern practice. It summarizes broad categories of concern, including increased documentation burden, more complex patient populations, greater use of screening and diagnostic services, patient communication expectations, and the role of electronic records and genetics. The article is relevant to physicians, medical coders, compliance staff, and reimbursement professionals following E/M valuation and Medicare fee schedule policy.
Why This Topic Matters
It highlights why specialty groups believe E/M work is more resource-intensive than older payment assumptions reflect, which can affect reimbursement policy discussions and practice revenue planning.
What You Will Learn
- Why physician organizations argue that E/M valuation should be revisited
- How changing patient care expectations affect evaluation and management work
- What broad practice trends are cited as increasing the complexity of office and hospital visits
- Why documentation, screening, and electronic communication are part of the payment debate
Who Should Read This
- Physicians
- Medical coders
- Coding auditors
- Compliance professionals
- Revenue cycle staff
- Practice managers
- Health policy analysts
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