Highlights of the Medicare Physician Fee Schedule Final Rule

Highlights of the Medicare Physician Fee Schedule Final Rule
RAC Monitor – November 14, 2018
by Deb­o­rah Grider CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP

Highlights of the 2019 Medicare Physician Fee Schedule, released on Nov. 1, are provided by the author.

There will be no change in E&M payment levels for 2019, as was proposed in the Centers for Medicare & Medicaid Services (CMS) proposed, rule, news that comes as a relief to many that expected to lose valuable revenue as a result. Practitioners may still use the 1995 or 1997 Documentation Guidelines for Evaluation and Management Services.

In addition, beginning Jan. 1, 2019 and running through 2020, the other good news is that CMS has relaxed the rules for documentation requirements for E&M services for new and established patients’ office visits. The entire history can now be recorded by ancillary staff. The practitioner must review and validate the information from ancillary staff for the history portion of the service to be counted, and the service must still be medically necessary. The rule goes on to state that if relevant information is already contained in the medical record, the practitioner may focus documentation on what has changed since the last visit, or on pertinent items that have not changed. The practitioner does not need to re-record these elements if there is evidence that the previous information was reviewed and updated. I recommend that if the information is reviewed, the practitioner either indicate this with a brief statement, or, if using an intake or history form for this information, sign and date the form to validate that the information was reviewed or updated.

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