Summary of 2015 Medicare Physician Fee Schedule (MPFS) Final Rule
On October 31st, 2014 CMS released final ruling on the 2015 Medicare Physician Fee Schedule (MPFS). This is a summary of that final rule.
In the proposed updates to MPFS, CMS had considered increasing the number of quality metrics used in Medicare Shared Savings Programs (MSSP) from 33 to 37. When making the final ruling CMS decided not to change the number of measures used, keeping it at 33.
However, CMS will create additional measures through claims while decreasing the number of measures that practices need to report through Group Practice Reporting Option (GPRO). This will effectively lower reporting requirements.
Furthermore, CMS will grant ACOs bonus points for year-over-year improvements (up to a determined maximum quality score). The potential for improvement-related bonus points was also increased from two to four points.
There will be a raft of changes to the Medicare Value-Based Payment Modifier (VBPM) starting January 1, 2015. These are;
The proposed rule had put reimbursement at $41.92; the final rule has reduced this to $40.39. The new code can be billed for a patient once every 30 days for any care coordination work within the care period that lasted at least 20 minutes. Two other key proposals were finalized;
Following an increased need to better understand differences in practice costs, healthcare data will now be collected exactly where medical services are provided.
Some specialty areas that had initially anticipated major Medicare payment changes will only be slightly impacted according to the Medicare final rule. These practices include independent labs, internal medicine, radiology, family practice, radiation oncology, and radiation therapy centers. Radiation in particular will see a -1 impact instead of the proposed -2.
You can find the complete MPFS changes on the Medicare website.
Healthcare Information Services (HIS) specializes in revenue cycle management for orthopedic and radiologic physicians, including everything from coding to collections.