Medicare Compliance & Reimbursement - 2005 Issue 44
E/M SERVICES: You May See More Reimbursement For The E/M Coding You're Already Doing
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Article Overview
This article reviews Medicare policy discussions that may affect reimbursement for evaluation and management services and other physician services. It covers MedPAC findings on relative value units, possible payment updates, review of payment inputs over time, and related topics involving chemotherapy payment adequacy, the Competitive Acquisition Program, and CMS demonstration projects. The piece is useful for physicians, coding professionals, compliance staff, and practice managers who follow Medicare payment trends and federal advisory recommendations.
Why This Topic Matters
Readers who code or manage physician services need to understand how Medicare payment policy changes can affect reimbursement patterns across E/M, imaging, procedures, and drug administration-related services. The article provides context for why payment levels may shift and flags broader CMS and MedPAC actions that can influence practice operations.
Article Sections
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MedPAC review of physician payment trends
Discusses changes in the relative share of physician spending and the broader payment context affecting office-based services and specialty services.
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Recommendations affecting RVU review and payment updates
Summarizes policy recommendations related to review of relative value units and possible physician payment updates for future years.
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Chemotherapy payment and access discussion
Addresses MedPAC’s review of chemotherapy payment adequacy, access concerns, and the impact of beneficiary cost-sharing on care settings.
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Competitive Acquisition Program and CMS demonstration projects
Covers recommendations involving drug vendor delivery under the competitive acquisition framework and the use of demonstration projects for health care innovation.
What You Will Learn
- How MedPAC is evaluating physician payment trends under Medicare
- What kinds of policy changes were being considered for RVU review and payment updates
- Why chemotherapy payment adequacy and beneficiary access were discussed together
- How CMS demonstration projects and drug delivery policy fit into broader payment reform
Who Should Read This
- Physician coders
- Medical billers
- Practice managers
- Compliance professionals
- Physicians
- Health policy analysts
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