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15% E/M Services Reimbursement Hike a Win for Rheumatology

Carina Stanton  |  February 19, 2020

Prior to implementation of the 2020 final rule, the ACR advocacy team, including volunteers and ACR staff, is joining forces with other cognitive specialties in Hill meetings to remind legislators of the importance of these updates to cognitive care. They are also emphasizing how much data and other information have been considered by the CMS in making this decision, according to Lennie Shewmaker, JD, ACR’s director of congressional affairs. “We remain in contact with CMS to support their rule as it was presented and urge them to implement that language as finalized in January 2021.”

Keep the Conversation Going
The ACR is also working with other cognitive care specialties to thank the CMS and members of Congress for their support of the rheumatology specialty and to offer support during implementation of the final rule, notes Amanda Grimm Wiegrefe, MScHSRA, ACR’s director of regulatory affairs. “We continue to advocate for implementation to occur on Jan. 1, 2021, as written,” she says, noting the ACR does not anticipate the fundamental E/M valuation increase to change in the next CMS Physician Fee Schedule proposed rule that is due out in July.

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Ms. Grimm Wiegrefe and other ACR staff are monitoring whether the complex care code (GPC1X) may be delayed to allow sub-regulatory guidance and to alleviate the dramatic reimbursement changes for other specialties.

In the meantime, the ACR continues to work with cognitive care colleagues to ensure the value of these specialties is appropriately recognized by payers, particularly the CMS. In this work, Ms. Shewmaker stresses the important role members can play by reaching out to their legislators to thank them for supporting these updates and urging them to support the CMS in implementing them on time.

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Send your thanks and support for these changes to members of Congress and follow developments on implementation of the E/M pay increase by visiting the ACR’s Legislative Action Center.


Carina Stanton is a freelance science journalist based in Denver.

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Filed under:Legislation & Advocacy Tagged with:evaluation and management (E/M) codesPhysician fee schedule

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