October 29, 2018

ACR Signs Letter Questioning Collapsed Payment Rates from Proposed E/M Policies

The ACR joined the American Medical Association (AMA) and approximately 170 medical groups in sending a letter to the Centers for Medicare and Medicaid Services (CMS) on the evaluation and management (E/M) proposals in the 2018 Medicare Physician Fee Schedule proposed rule.

The groups are supportive of the agency’s efforts to reduce the burden of extensive documentation requirements for E/M services in accordance with its “Patients Over Paperwork” initiative. There is significant concern among the organizations regarding CMS’ proposal to collapse payment rates for the various levels of E/M services. The ACR is particularly concerned that the proposal unfairly punishes those physicians who treat the sickest and most complex patients. There also appears to be an unintended consequence impacting indirect practice expense cost calculations.

The ACR supports the newly formed AMA workgroup, which is working to analyze the E/M coding and payment issues with a goal of providing suggested solutions to CMS to include in 2020 rulemaking.
For more information, contact Kathryn Keysor, ACR Senior Director of Economics and Health Policy, at kkeysor@acr.org.