CMS Finalizes 2018 MPFS Payment and Policy Changes
The Centers for Medicare & Medicaid Services (CMS) has finalized 2018 payments and policies under the Medicare Physician Fee Schedule (MPFS). Most notable is the leniency in adopting federally-mandated policies.
MPFS Final Rule Highlights
Taking into account the 0.5 percent automatic adjustment under the Medicare Access and CHIP Reauthorization Act (MACRA), CMS estimates the resource-based relative value scale (RBRVS) for 2018 to be $35.9996.
CMS is lowering the 2016 Physician Quality Reporting System (PQRS) and Medicare Electronic Health Record Incentive Program reporting requirement from nine measures across three National Quality Strategy (NQS) domains to only six measures with no domain or cross-cutting measure requirement, which should make it easier for providers to earn additional quality incentive payments in 2018.
Other notable provisions CMS is finalizing include:
- A one year postponement of the Appropriate Use Criteria (AUC) consulting and reporting requirement for advanced diagnostic imaging services. The effective date is now Jan. 1, 2020.
- The use of HCPCS Level II modifiers as patient relationship codes, as required by MACRA. Use will be voluntary for an unspecified length of time.
Here Is What the Industry is Saying
The American Society of Anesthesiologists (ASA) reported several code changes for anesthesia services related to gastrointestinal endoscopy. The society also noted work value decreases for intravascular catheterization codes and “significant” work value increases for percutaneous implantation of neurostimulator array codes. The hardest hit, with a combined impact of -2.0 percent on allowed charges, will be nurse anesthetists and their assistants, the ASA reported.
The American Society of Echocardiography announced, “We are pleased that CMS has accepted the RUC recommendation to increase the wRVUs for CPT code 93306 from 1.30 to 1.50 RVUs.”
Read All About It
The final rule went on display at the Office of the Federal Register’s Public Inspection Desk on Nov. 2, and will be available until the regulation is published on Nov. 15. You can also download the final rule on CMS’ website in the “Related Links” section. Addendum and lists, such as the Anticipated Specialty Assignment for Low Volume Services list, are in the “Downloads” section on the same website.