Part B Insider - 2017 Issue 9
Part B Fee Schedule: 2018 Medicare Fee Schedule Proposes Major Updates to ED Services
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Article Overview
This article explains proposed CMS changes in the 2018 Medicare Physician Fee Schedule that could affect emergency department E/M services. It discusses the potential review of ED visit valuation, possible shifts in documentation expectations for history and physical exam, and stakeholder reactions from the emergency medicine and revenue cycle community. The piece is relevant to ED coders, billing teams, physicians, and compliance professionals monitoring Medicare policy and E/M documentation trends.
Why This Topic Matters
The proposal could influence how emergency department services are valued and documented under Medicare Part B. Readers who code or bill ED visits need to understand the direction CMS is considering and why the proposed changes may affect reimbursement, workload, and payer review.
Article Sections
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Potential ED Pay Boosts
Summarizes CMS commentary on emergency department visit valuation and the possibility of review under a misvalued code initiative. It also notes the broader policy context involving Medicare payment updates and stakeholder input.
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Potential E/M Documentation Changes
Covers proposed changes to E/M documentation guidance, including CMS interest in revisiting history and physical exam requirements. The section also reflects differing stakeholder perspectives on documentation burden and coding impact.
What You Will Learn
- What CMS proposed for emergency department visit valuation in the 2018 Medicare Physician Fee Schedule
- What documentation areas CMS is considering revising for E/M services
- How proposed Medicare policy changes may affect emergency department coding and billing stakeholders
- Why professional and industry groups are paying attention to the proposed rule
Who Should Read This
- Emergency department coders
- Medical billers
- Revenue cycle professionals
- Physicians and clinicians
- Compliance staff
- Practice administrators
Code Ranges Discussed
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