On July 11, 2014, the Center for Medicare and Medicaid Services (“CMS”) published its proposed annual update to the Medicare physician fee schedule. The proposed fee schedule implements changes required by the Patient Protection and Affordable Care, updates the relative value units (RVUs), and makes other adjustments to the services for which Medicare will reimburse physicians. Notably, the fee schedule adds four services to the telehealth benefit, including annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management services. The fee schedule also proposes a payment rate for chronic care management services and allows for greater flexibility in the supervision of clinical staff providing such services. Additionally, the fee schedule adds approximately eighty codes to the list of potentially misvalued codes, which CMS will review and adjust the payment if CMS determines that the code has been misvalued. The Protecting Access to Medicare Act of 2014 avoided the Sustainable Growth Rate’s (“SGR”) mandated 2.4% reduction until March 1, 2015. The fee schedule notes that if Congressional action is not taken to update the SGR, then beginning March 1, 2015, the RVU conversion factor will reflect the 2.4% reduction. The actual values used to calculate physician payments will be published as part of the final rule, which will be published by November 1, 2014. CMS is accepting comments to the fee schedule through September 2, 2014.
The complete proposed fee schedule may be found here.
Mathew Klein is a Partner in the law firm of Dressman Benzinger LaVelle, with offices in Cincinnati, Ohio, Crestview Hills, Kentucky, and Louisville, Kentucky
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