CMS Fee Schedule for the physicians was issued on 1st November 2019 to be used for availing health services from 1st January 2020 onwards. This schedule served as an incentive for primary care physicians who used to avoid providing primary level services due to excess burnout and heavy paperwork. This schedule curtailed the need for excess paperwork and allowed them to pay more heed to care to take and providing better health services. With these changes in place, there will be more influx of physicians towards primary care disciplines, which usually remained undervalued and were being avoided by most of the physicians. The changes undertaken by CMS under Physicians Fee Schedule 2020 of Medicare are as follows:
Under the new changes made by CMS, primary care physicians will see higher reimbursements for services related to evaluation and management. Primary care physicians will be better off with new proposed payment schedule according to which level 2 visits and level 3 office/outpatient visits of new patients and level 1, level 2 and level 3 outpatient or office visits of established patients will receive higher reimbursements according to CMS codes.
Simplified Billing Requirements
There will be coding, and billing of evaluation and management related services based on more simplified requirements. The aim of opting for these is to make healthcare a priority rather than indulging in avoidable documentation and procedures. Information crucial to the patient’s health will be recorded; however, physicians will be freed from the long procedures associated with the old practice system. This will not only alleviate the stress from physicians’ shoulders but also provide higher payments.
Increasing PFS Payments
Starting from the New Year, CMS has declared to raise the payments of the PFS conversion factor. PFS conversion factor is involved in converting RVUs (Relative Value Units) into the payable amount. Besides, E/M visits will cash more be it office visits or outpatient visits. Physicians will be able to get higher payments for patient visits who need extra care and are subjected to multiple medical conditions.
Coding Changes and Add-on Services
Higher payments are a result of some coding changes and add-on updates into the existing medical payment system. These changes include using values for office and outpatient E/M codes recommended by the American Medical Association. To increase the service time, there is a new CPT code introduced. Moreover, there are some other changes in E/M coding recommended by the American Medical Association that are responsible for higher payments such as:
Reducing the number of office or outpatient visits for Evaluation and Management services for new patients
- All the codes with revised definitions, time and medical decision-making process.
- History and exam will be performed or required precisely as medically appropriate.
- Time and medical-decision making will be the deciding factor for choosing E/M visits by the physicians and clinicians.
Reduced Documentation and Paperwork
With new and improved coding, not only is the need for paperwork reduced but also has made streamlined. Physicians are to faceless burden compared to what they had to face before when they had to juggle between administrative tasks and medical care duties. They will not be required to reenter the history of patients except the changes made since the last visit. Moreover, they will not be required to document history in the case of established patients. Some of these administrative tasks will be directed to ancillary staff.
There are no unnecessary requirements for documentation and paperwork. They need to focus on recording time and following the guidelines of CMS. However, doctors are required to keep records crucial to patients’ health.