AANEM News Express

AANEM News Express

2015 Medicare Fee Schedule: CMS Predicts Zero Impact on EDX Physicians

On July 3, 2014, CMS issued a proposed rule updating payment policies and rates for physicians under the Medicare Physician Fee Schedule (MPFS) in 2015. According to this proposed rule, CMS projects that allowed charges for electrodiagnostic (EDX) physicians will remain neutral in 2015. Even though CMS estimates a 0% impact on neurology and physical medicine, ultimately the result could differ when the final rule is published on November 1.

However, some areas of interest addressed in the proposed 2015 MPFS include:
  • Transparency in rate setting: CMS has proposed to allow public comment on values for new and revised codes before they are finalized starting in the 2016 rulemaking cycle.
  • Global surgical periods: CMS has proposed to eliminate 10- and 90-day global periods by transitioning over several years all 10- and 90-day global codes to 0-day global codes.
  • Proposed updates to the Physician Compare website: They include a quality programs section, a broader set of quality measures, and recognition for individuals who have successfully participated in the electronic health record (EHR) incentive program.
  • Physician Quality Reporting System (PQRS): CMS is proposing to require physicians who see at least one Medicare patient in a face-to-face encounter to also report on at least two measures from a newly proposed cross-cutting measure set; these would be in addition to the nine measures they already are required to report.
  • EHR Incentive Program: CMS is proposing to no longer require that EHR products be recertified to the most recent version of the electronic specification for clinical quality measures.
  • Value-Based Payment Modifier: In 2015, all EDX physicians, including solo practitioners, will be subject to the 2017 value modifier based on the 2015 PQRS performance period. CMS proposes an increase to the maximum penalty from 2-4% as well as make quality-tiering mandatory for all physicians.
The public and the AANEM have an opportunity to comment by September 2, 2014, on these proposals before they are released in the final rule. Contact the policy department at policy@aanem.org with any questions or concerns.

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