CMS Issues Proposed Payment Provisions Changes to the Medicare Physician Fee Schedule for 2019

Friday, August 10, 2018
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update payment policies, payment rates, and quality provisions for services rendered under the Medicare Physician Fee Schedule (PFS). If passed, the proposed rule would be effective January 1, 2019.

Background Info.

Payment is made under the PFS for services rendered by physicians and other practitioners in all sites of service. These services include, but are not limited to, visits, surgical procedures, diagnostic tests, therapy services, and specified preventive services.

In addition to physicians, payment is made under the PFS to a variety of practitioners and entities, including nurse practitioners, physician assistants, and physical therapists, as well as radiation therapy centers and independent diagnostic testing facilities.

Payment Provisions.

CMS is proposing a number of coding and payment changes to reduce administrative burden and improve payment accuracy for E/M visits. To view the payment changes, click here to view CMS’s fact sheet.

For more information, visit

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“Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019.” (July 31, 2018). Web.

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