On November 1, the Centers for Medicare and Medicaid Services (CMS) released the 2019 Medicare Physician Fee Schedule (MPFS) final rule which follows many of the recommendations provided by the American Academy of Family Physicians. The AAFP has produced a four-page summary of the final rule and its key provisions. Additionally, AAFP News published an excellent summary article.
The AAFP issued a statement attributed to AAFP President John Cullen, MD, citing that the final rule “Is a step forward in easing administrative burden and improving patient access to care”. CMS decided to delay implementation of its controversial proposal to restructure evaluation and management (E/M) codes until 2021.
“Administrative burden will be reduced as a result of the rule’s elimination of the requirement to re-record elements of the patient’s history and physical examination when there is evidence the information has been reviewed and updated and removing potentially duplicative requirements for notations in medical records that others on the medical team have logged.
“We are pleased that CMS will not immediately implement a proposal to restructure E/M codes; these changes have been delayed until 2021. We will work closely with CMS and other stakeholders in the intervening years to develop modifications that both ensure appropriate payment for E/M visits and meet CMS’s goal of further reducing administrative burdens on physicians.
“We are equally pleased that CMS will not implement a proposal that would have reduced payment for multiple procedures provided in a single office visit. As a result, patients will not be required to make a separate appointment—and pay the corresponding deductible or copayment—for a medical service that surfaces during an appointment.
“Patient access to care will improve as a result of two newly defined physician services using communication technology. The AAFP supported this proposal, which provides new, separate payments for virtual check-ins and other brief technology-based communication, and remote evaluation of video or images submitted by an established patient. This will enhance access to timely patient care, particularly for those who struggle with transportation barriers.
“The AAFP applauds CMS for implementing, as part of a separate final rule, the AAFP’s recommendation to establish site-neutral payments for medical services, regardless of whether they are provided in a community-based physician’s office or a clinic designated as a hospital outpatient department. This discrepancy has encouraged hospital purchases of physician practices, reduced Medicare patients’ choices for medical care and increased beneficiaries’ out-of-pocket expenses. Ending this disparity will serve patients and the community on multiple levels.”