tci Medicare Compliance & Reimbursement - 2016 Issue 15
Reimbursement: Proposed Fee 2017 Schedule Closely Aligned to MACRA
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Article Overview
This article reviews major CMS proposals for the 2017 Medicare Physician Fee Schedule and explains the broad policy areas they target. It is aimed at coders, billers, physicians, and practice leaders who want to understand how the proposed changes relate to primary care, preventive services, chronic care management, telehealth expansion, global service valuation, and sedation-related updates. The discussion stays at a high level and focuses on the types of revisions CMS is considering rather than detailed coding instructions.
Why This Topic Matters
The proposed changes affect how several categories of physician services may be recognized and valued under Medicare. Readers who follow reimbursement policy or code updates can use the article to gauge whether the CMS proposals may affect their specialty, workflow, or compliance planning.
Article Sections
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Patient-focused initiatives are front and center
Introduces the article’s emphasis on primary care, chronic condition management, and mental health support within the 2017 fee schedule proposals. It also frames the broader policy goals CMS is pursuing.
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Putting the nation’s health first
Summarizes the proposed Medicare Diabetes Prevention Program and the related implementation considerations discussed by CMS. The section addresses the public-health and operational context for the program.
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Look for potential modifier 25 overhaul
Covers CMS’s review of global services valuation and related data collection efforts, along with telehealth and sedation-related proposal areas. It highlights the categories of services under review in the proposed rule.
What You Will Learn
- Which broad Medicare payment policy areas are addressed in the 2017 proposal
- How CMS is approaching primary care and chronic care priorities
- What categories of telehealth and preventive services are being discussed
- Why global services valuation and sedation-related updates are part of the proposal set
- What implementation issues are being considered for new or expanded Medicare services
Who Should Read This
- Medical coders
- Billing professionals
- Physicians
- Practice managers
- Revenue cycle teams
- Compliance staff
- Health policy readers
Code Ranges Discussed
Modifiers Discussed
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