Physician Fee Schedule



The CY 2020 Physician Fee Schedule (PFS) proposed rule has been released on July 29 which included changes to the conversion factor for Medicare physician reimbursement ($36.09). In the proposed rule, CMS announces its intentions to pull back on establishing blended payment rates for established patient office visits coded as E/M levels 2 through 4. Instead, the rule would revert to separate codes and payment rates for the five E/M levels.

The new proposed rule also contained several policies that aim to reduce the burden for providers and improve health outcomes, including allowing providers to review and verify notes for other members of a medical team, increasing payments for transitional care management, and adding chronic care management codes, and establishing reimbursement for opioid use disorder treatment services.

Although the rule would reduce the number of levels to four for office/outpatient E/M visits for new patients and revise certain code definitions, CMS pointed out in the proposed rule.

CMS noted in the rule that the agency decided to reverse course after provides in outreach sessions expressed concerns that the blended payment rates would inappropriately incent multiple or shorter patient visits, which could result in providers treating less complex patients.


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