Payment & Practice Management  |   February 2019
2019: Unanswered Questions Remain
Article Information
Pain Medicine / Practice Management / Advocacy and Legislative Issues / Payment & Practice Management / Opioid
Payment & Practice Management   |   February 2019
2019: Unanswered Questions Remain
ASA Monitor 2 2019, Vol.83, 48-49.
ASA Monitor 2 2019, Vol.83, 48-49.
We are now one month into 2019, and much of the hustle over all that needs to be updated at the start of each year should be behind us. This may be a good time to return to the Centers for Medicare & Medicaid Services’ (CMS’) Final Rule for the 2019 Medicare Physician Fee Schedule (MPFS) to see what elements other than conversion factors, code valuations and Quality Payment Program (QPP) updates are in the rule and may impact anesthesia and pain medicine practices in 2019 – and beyond.
Significant revisions to evaluation and management E/M coding, documentation and payment were under consideration for 2019. The most dramatic being consolidation of the five different payment amounts for office/outpatient E/M services into two amounts, implementing a 50 percent payment reduction when an E/M and a procedure are performed on the same date of service and changes to the documentation requirements necessary to support the level of E/M service reported. CMS did finalize certain provisions to streamline E/M documentation for 2019 and announced that it would not move forward with the 50 percent payment reduction. However, CMS has some big changes lined up for 2021. Effective in 2021, CMS plans to use three payment amounts for office/out-patient E/M, with differentiation for new and established patients.
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