The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / 15% E/M Services Reimbursement Hike a Win for Rheumatology

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

February 19, 2020 • By Carina Stanton

  • Tweet
  • Email
Print-Friendly Version / Save PDF

The Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule final rule for 2020 includes a big win for rheumatologists—a 15% increase in reimbursement for evaluation and management (E/M) services. This decision represents an historic hike in payment for these codes and resulted from 10 years of advocacy work by the ACR and other cognitive care specialists.

You Might Also Like
  • Final 2019 Physician Reimbursement Rule Released by CMS Includes Victories for Rheumatology
  • ACR Leads Fight Against Proposed Reimbursement Cuts to E/M Services
  • CMS Proposes Major Payment Increases for E/M Services
Also By This Author
  • Sleep Tips for RA Patients & Rheumatologists

The change is set to take effect in January 2021 and is based on revised E/M code definitions developed by the American Medical Association (AMA) CPT Editorial Panel and RUC-recommended values for these services. It will replace the single payment rate policy for level 2–5 services that had previously been proposed by the CMS. The final Physician Fee Schedule also includes a new complexity code that can be added under certain conditions to reflect rheumatologists’ evaluations in cognitive care.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

“We are thrilled that this final rule by CMS resulted in significant potential increases in reimbursement to rheumatology providers for their work,” notes Blair Solow, MD, chair of the ACR’s Government Affairs Committee (GAC). “This increase in reimbursement will enable us to recruit young residents into the field of pediatric and adult rheumatology, which in turn will lead to better access to rheumatology providers for patients.”

Reducing Administrative Burden
The immediate impact of this reimbursement increase on the practicing rheumatologist is to alleviate the pressure felt in caring for complex patients, according to Colin Edgerton, MD, FACP, RhMSUS, chair of the ACR’s Committee on Rheumatologic Care (CORC). “Proper valuation of E/M allows rheumatologists to spend the time needed with these patients, and to hire the professional staff needed to coordinate the complex needs these patients have. Similarly, the reduction in administrative burden through measures such as documentation simplification allows rheumatologists and rheumatology professionals to focus on patient care rather than on paperwork.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Physicians are often required to spend significant time documenting in electronic medical records (EMRs)—often far longer than the face-to-face patient encounters, Dr. Edgerton adds, noting that “much of the documentation is clinically meaningless and is required only for coding and billing purposes—rheumatologists are eager to return documentation to a clinically meaningful exercise.”

Recognizing the Cognitive Specialties
The E/M reimbursement increase also sends an important message that cognitive specialties, such as rheumatology, are valued, which can make rheumatology practice more attractive to medical students and residents at a time when the field faces critical workforce shortages.

Timothy Laing, MD, the ACR’s liaison to the AMA’s RUC and CPT advisory committee, says this E/M increase is far and away the most significant he has seen during his many years of advocacy for payment reform. He notes that credit for this win is shared by many, including the GAC, CORC and ACR’s board of directors and executive committee members. He also points to the Cognitive Care Alliance as an important partner in lobbying and advocacy activities on this topic.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 | Single Page

Filed Under: Legislation & Advocacy Tagged With: evaluation and management (E/M) codes, Physician fee schedule

You Might Also Like:
  • Final 2019 Physician Reimbursement Rule Released by CMS Includes Victories for Rheumatology
  • ACR Leads Fight Against Proposed Reimbursement Cuts to E/M Services
  • CMS Proposes Major Payment Increases for E/M Services
  • Proposed 2020 E/M Codes Include Reimbursement Changes

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)