RPA Seeks to Reverse E&M Code Change Proposals

The 2019 Medicare Fee Schedule proposed rule included a relatively stunning proposal to revise evaluation and management (E&M) services in Medicare by collapsing reimbursement for the outpatient E&M code families (CPT codes 99201-99205 and 99211-99215) for levels 2-5 to single payment rate set between that of the current levels 3 and 4.

While this is coupled with a proposal to reduce the documentation burden associated with these services that is viewed somewhat positively, the proposed reimbursement changes have been met with tremendous resistance from RPA and the majority of organized medicine. RPA has been actively participating in efforts to seek relief from this ill-considered proposal as an individual organization, within the context of internal medicine, and as part of a broader coalition of specialty groups.

https://www.federalregister.gov/documents/2018/07/27/2018-14985/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions

Source: RPA