Medicare imposed substantial cuts in reimbursements for the new and revised fine needle aspiration codes for 2019. AACE, together with the Endocrine Society and American Thyroid Association, advocated for you with letters to Centers for Medicare and Medicaid Services (CMS) and Congress opposing these cuts. We secured a win with the release of the proposed physician pay rule issued July 29. CMS has listed the FNA codes under the “potentially mis-valued” list, giving an opportunity for codes to be reviewed. AACE plans to write in support of the mis-valued list as a first step to securing a higher value associated with the FNA codes.
The proposed Medicare rule also contains several positive developments for relating to the evaluation and management codes and guidelines. Beginning January 1, 2021, CMS will adopt the CPT-recommended guidelines to report office visits based on either medical decision making or physician time. CMS is also proposing to pay for care management services for patients with a single, high-risk chronic condition such as diabetes, and for additional time spent on care management activities for patients living with multiple chronic conditions.
The CMS rule also proposes streamlining the Quality Payment Program by moving MIPS to a system where clinicians report on a smaller set of measures that are specialty specific and outcome based.
This is great news and a win for AACE and all in the medical specialty community who mobilized to oppose the initial E/M proposals by CMS. Your individual letters to CMS and contacts to Congress on this issue, resulting in bipartisan letters from both the House and Senate to CMS opposing these provisions, clearly helped to reverse the agency’s thinking. Thank you for all your efforts! They really made a difference!
All Public comments on the proposed rules are due by September 27, 2019.
For a fact sheet on the CY 2020 Physician Fee Schedule proposed rule, please click here.
For a fact sheet on the CY 2020 Quality Payment Program proposed rule, please click here.
To view the CY 2020 Physician Fee Schedule and Quality Payment Program proposed rule, please click here.