CMS Proposes Landmark Changes In How Evaluation and Management Services Will Be Paid

Breaking News……………CMS Proposes Landmark Changes In How Evaluation and Management Services Will Be Paid!

 The Centers for Medicare and Medicaid Services(CMS) published proposed changes in how physicians will be paid for Evaluation and Management(E & M) services in a non facility setting.  In an effort to shift the focus from redundant documentation to patient-centered medical decision making, CMS is proposing that all Level 2-5 E & M services be collapsed and consolidated into just two payment amounts. One payment amount would be for New Patients and the second payment would be for Established Patients.

Based on the CMS proposed 2019 fee-for service conversion factor of $36.05, the two new proposed national average consolidated payment amounts would be:

NEW PATIENT OFFICE VISIT CONSOLIDATED PAYMENT                         $135.00

ESTABLISHED PATIENT OFFICE VISITS CONSOLIDATED PAYMENT     $93.00

 SPPM believes that these changes are long overdue and represent a big step in the right direction by helping reduce the onerous administrative and documentation requirements for our members.