Regulatory Alert: CMS releases proposed 2018 Medicare physician fee schedule

14 Jul 2017 7:49 AM | Anonymous
July 13, 2017

Regulatory Alert: CMS releases proposed 2018 Medicare physician fee schedule

The Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule (PFS) rule for 2018. CMS will accept public comments on the rule until Sept. 11, 2017 and intends to issue the final 2018 PFS by Nov. 1, 2017. Visit our updated Medicare Physician Reimbursement webpage to view the full proposed 2018 Medicare PFS and read the CMS fact sheet under the "Other Resources" section.

Among other changes, the proposed rule would:
  • Set 2018 Medicare payment rates for physician services, including a modest payment increase as a result of SGR repeal under the Medicare Access and CHIP Reauthorization Act;
  • Outline proposed RVU and payment changes for services CMS considers misvalued; 
  • Delay the start of the Appropriate Use Criteria (AUC) program until Jan. 1, 2019 and posts the list of newly approved Provider-Led Entitles and Clinical Decision Support Mechanisms, which will develop and document AUC for advanced diagnostic imaging services;
  • Retroactively lower PQRS reporting requirements to six measures;
  • Reduce Value-Based Payment Modifier penalties and hold groups harmless if they meet minimum quality reporting requirements; and
  • Seek input through a Request for Information about opportunities to reduce burdens on physician practices and make the delivery system less bureaucratic and complex.
In a separate rule, CMS proposed changes to policies and payments regarding hospital outpatient departments and ambulatory surgical centers.

MGMA will prepare an in-depth analysis of the proposed 2018 Medicare PFS for members and submit comprehensive comments to the agency. Stay tuned to the MGMA Washington Connection for updates and contact MGMA government affairs with questions by emailing govaff@mgma.org or calling 202.293.3450877.275.6462 toll-free.