Coffee with Coker

Episode 22: Espresso Shot #5: Changes to Reimbursement from CMS for CY 2019

  • December 13, 2018

Brandt Jewell and Alex Kirkland join Mark to discuss the final rule from CMS last month announcing adjustments to the physician fee schedule for 2019. Brandt and Alex provide their input on the changes revealed and what it means for physician practices.



Episode Synopsis

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.

Key Points from the Final Rule

  • One of the payment provisions announced involved streamlining evaluation and management payment and reducing clinician burden.
  • Beginning in CY 2021, payment for E/M office/outpatient visits will be simplified and pay would vary primarily based on attributes that do not require separate, complex documentation.
  • After consideration of concerns raised by commenters in response to the proposed rule, CMS is not finalizing aspects of the proposal that would have:
    • Reduced payment when E/M office/outpatient visits are furnished on the same day as procedures;
    • Established separate coding and payment for podiatric E/M visits;
    • Standardized the allocation of practice expense RVUs for the codes that describe these services.

Brandt and Alex hosted a webinar on January 24, 2019 covering the potential ramifications for physicians and healthcare organizations. View the webinar!


Final Policy on Payment and Quality Provision Changes to the Medicare Physician Fee Schedule for CY 2019

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  • Brandt Jewell

    Brandt Jewell

    Senior Vice President

  • Alex Kirkland

    Alex Kirkland

    Vice President


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