DWW special issue: 2019 proposed fee schedule


DWW special issue: 2019 proposed Medicare Fee Schedule

On July 12, the Centers for Medicare and Medicaid Services (CMS) released its 2019 proposed Medicare Fee Schedule, which also includes changes to its proposed policies for the 2019 Quality Payment Program (QPP). Dermatology World Weekly is unpacking the meaning of the 2019 proposed Medicare Fee Schedule in a seven-part series. Each Wednesday an article covering a new topic of the fee schedule will be published. Read the articles that have already been published below, and check back to read all seven articles of the series.

5 Things to know about the proposed Medicare Fee Schedule

In addition to an overall 1% payment cut in 2019 for dermatology, the rule also proposes substantial changes to reporting and payment for in-office evaluation and management (E/M) codes among other areas of significance to dermatology. While the exact impact of the rule will depend on your practice mix, DWW breaks down what the proposals might mean for dermatology and how the AADA is responding on the specialty’s behalf. 

In this first article, we highlight what is most important to dermatology. Keep reading!

The good, the bad, and the unknown in CMS E/M proposals

Proposals in the draft Medicare Fee Schedule would significantly overhaul payment and documentation for E/M codes. Depending on your payment mix, the news may be somewhat welcome, but proposed cuts to modifier 25 are bad news for the specialty overall. And, while CMS’s attempt to simplify documentation is a move in the right direction, the changes need clarification.

In the second article, we take a closer look at what these documentation and E/M changes may mean for dermatology. Keep reading!

6 new biopsy codes for 2019

Among many suggested changes, the CMS Medicare Physician Fee Schedule proposed rule unveils values for six new biopsy codes (three primary codes, each with an add-on code) recommended by the American Medical Association Relative Value Scale Update Committee (or “RUC”) and CPT® following recent surveys of dermatologists. 

In the third article, we dive deeper into the new biopsy codes. Keep reading!

CMS questions global payment codes

While they haven’t made a move yet, CMS is asking some hard questions about global surgical codes in the proposed 2019 Medicare Fee schedule. The agency wants to know whether the follow-up visits assumed in the payment for the 10- and 90-day codes are in fact happening. 

In the fourth article, we delve into CMS's concerns about global payment codes. Keep reading!

CMS values virtual appointments

While dermatologists have long been among the physician leaders in adopting telemedicine technology to meet patient care demands, payment has been a lot slower to catch up. CMS made a major move to address that gap in the proposed 2019 Medicare Physician Fee Schedule. 

In the fifth article, we review proposed new HCPCS codes as well as changes in coverage for existing CPT codes. Keep reading!

CMS continues to tinker with MIPS in 2019 proposal

CMS announced plans for the latest evolution of the MIPS program in the proposed fee schedule. CMS will score your 2019 MIPS performance in three categories, with adjustments to the category weights, placing more emphasis on the cost category. 

In the sixth article, we break down topline changes to each MIPS category. Keep reading!

What did the AADA have to say about the proposed fee schedule?

The comment period for the 2019 proposed Medicare Physician Fee Schedule is now closed. In its comment letter to CMS, the AADA expressed appreciation for the opportunity to review and provide comments on the proposed rule and urged CMS to take a series of recommendations and concerns into consideration when developing the final rule and formulating future policy.

Read more about the AADA's recommendations and concerns outlined in its comment letter to CMS. Keep reading!