AMA Welcomes Burden Relief Finalized in Medicare Payment Rule

Dec 06, 2020 at 12:00 am by Staff



Statement attributed to: AMA President Susan R. Bailey, M.D.

"Foundational improvements are coming on January 1 to the coding, documentation, and payment of evaluation and management (E/M) services for office visits as the newly announced Medicare payment rule finalized revised guidelines and payment rates.

"These Medicare enhancements match the physician-led recommendations of an AMA assembled joint work group representing the Current Procedural Terminology Editorial Panel and the AMA/Specialty Society RVS Update Committee. The process for coding and documenting E/M office visit services is now simpler and more flexible, allowing physicians to select the appropriate code based on medical decision-making or total time.

"Unfortunately, the newly adopted office visit payment rates, and other payment increases finalized in today's rule, are required by statute to be offset by payment reductions to other medical services covered by Medicare. This will result in a shocking reduction of 10.2% to Medicare payment rates in the midst of the worsening COVID-19 pandemic while physicians are continuing to care for record numbers of patients diagnosed with COVID-19 and trying to keep the lights on in their practices. These cuts will hurt all Medicare patients, particularly those seeking care for COVID-19 critical care and hospital visits that will be reduced dramatically.

"For this reason, the AMA strongly urges Congress to prevent or postpone the payment reductions resulting from Medicare's budget neutrality requirement. Physicians are already experiencing substantial economic hardships due to COVID-19, so these payment cuts could not come at a worse time.

"For several months, the AMA has been helping physicians prepare for getting the full benefit of the burden relief from the E/M office visit changes and offers authoritative instructional resources that includes a checklist, videos, modules, guidebooks, as well as other tools and references to help physicians adapt to the operational, infrastructural and administrative workflow adjustments that will result from the transition."

Sections: Regulatory/Compliance