10 Medicare PFS Revisions You Need to Know

The AMA has identified the “top 10” policy changes in the 2015 Medicare Physician Fee Schedule final rule. Below is a quick summary; the full document is available here.

1. The sustainable growth rate (SGR) formula calls for a 21.2% cut to physician payments, effective April 1.
2. Continuing medical education (CME) will not be reported under the Physician Payments Sunshine Act.
3. Proposed penalties under the value-based payment modifier (VBM) will be scaled back.
4. The Physician Quality Reporting System (PQRS) becomes a penalty-only program next year.
5. The Physician Compare website will continue to expand – but not as much as planned.
6. Chronic care management services will be supported by a monthly payment.
7. Four services now are eligible for telehealth payment.
8. Surgical global periods will change from 10-day and 90-day periods to 0-day periods.
9. There are 350 CPT codes identified as new, revised or potentially misvalued – 318 of these changes were based on physician input.
10. The timeline for submitting new codes and revaluations of services will shift.

On 12/2, CMS will host a National Provider Call on theses Final Rule changes. The call will cover PQRS, VBM, Physician Compare, EHR Incentive Program, Comprehensive Primary Care Initiative (CPC), and Medicare Shared Savings Program; a Q&A session will follow the presentation. Register now for this important call.

For additional information, please see the CMS Fact Sheet: Policy and payment changes to the Medicare Physician Fee Schedule for 2015.

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