2018 Medicare Fee Schedule Final Rule

The estimated impact on dermatology is +1%

In November, the Centers for Medicare and Medicaid Services (CMS) released the final 2018 Medicare Fee Schedule rule. The rule, which goes into effect January 1, 2018, includes a number of important wins for dermatology. While the fee schedule changes vary by individual physician practice characteristics, the estimated impact on dermatology is +1%. View the fee schedule.

In response to AADA advocacy, the final rule:
  • Retroactively lowers Physician Quality Reporting System (PQRS) reporting requirements to 6 measures from 9 measures;
  • Updates the value of the existing photodynamic therapy (PDT) code and created two new PDT codes that involve physician work. The code values for acne surgery and photochemotherapy increased slightly;
  • Reduces value-based modifier penalties for those not meeting minimum reporting requirements.
The final rule also:   
  • Signals intent to consider ways to further expand access to telehealth services;
  • Finalizes a proposal to separately code and pay for biological biosimilar products under Medicare Part B. Effective January 1, 2018, newly-approved biosimilar biological products will be billed differently than the reference product. This is intended to encourage competition on product availability and price.

View a fact sheet on this rule on the CMS website.