Rheumatology and the ACR scored a major win on evaluation and management (E/M) payments in the 2020 physician fee schedule proposed rule, which was released by CMS on July 29.
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CMS estimates that under their proposal rheumatologists would see on average a 15% payment increase, beginning in 2021. The proposed coding changes recognize the value of time spent with complex patients.
Last year CMS proposed a code collapse that would have resulted in large cuts to rheumatology. CMS gave the physician community time to develop a better solution, and after sustained advocacy by the ACR and our specialty partners along with the American Medical Association, the agency’s new proposal aligns with recommendations set forth by the AMA in collaboration with physician societies, including the ACR. The ACR also engaged the administration through meetings, phone calls, and public comments to provide the perspective of rheumatologists. The ACR’s advocacy leadership was highlighted in national media, including the New York Times and National Public Radio.
If finalized, the CMS proposal would increase Medicare reimbursement for time-intensive healthcare services provided by cognitive specialists such as rheumatologists. These services include examinations, disease diagnosis, risk assessments, and care coordination. The result would be an increase in reimbursement across the board for rheumatology beginning in CY 2021.
The ACR thanks all advocates who joined in voicing concerns and helping in advocacy with CMS, along with our partners and with support from the AMA.
Read the ACR’s media statement here, and watch for more news and analysis from the ACR in coming weeks.