CMS Releases Proposed Physician Fee Schedule Rule for CY 2019

Jul 16, 2018

Patricia Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC has over 35 years expertise in the areas of ICD-9-CM, CPT, DRG/APC validation Professional Fee E&M coding, Interventional Radiology, and Facility E&M coding. Patricia is currently Director of Education a healthcare consulting firm specializing in coding compliance review, education and contract coding services.

Pat Maccariella‑Hafey

Executive Director Of Education
AHIMA‑Approved ICD‑10‑CM/PCS Trainer and Ambassador


Deadline for comments is September 10, 2018

The 2019 Medicare Physician Fee Schedule proposed rule has been released!

There are several blockbuster proposals to physician E/M reporting that you don’t want to miss.

Among them are:

  • Possible single payment of $93 for levels 2 to 5 established patient visits
  • Possible single payment of $135 for levels 2 to 5 for new patient visits
  • Significantly reduced documentation requirements:
    • One proposal to use time OR Medical Decision Making ONLY and scraping the history and physical components!
    • Another proposal, providers could report history and exam but only note what has changed or verify some information from ancillary staff rather than re-documenting it
    • Providers could continue to use the old E/M guidelines as they have been.
  • Proposed add-on G code for primary care focused visits
  • Proposed add-on G code for specialists
  • Proposed new podiatry office/outpatient E/M G codes

Read the CY2019 Physician Fee Schedule Proposed Rule in full:

The deadline to submit comments is September 10, 2018 at 5 pm.

The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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