On Nov. 1, after months of advocacy efforts spearheaded by the ACR and others, the Centers for Medicare and Medicaid Services (CMS) released the CY 2019 Medicare physician fee schedule rule, and it included several victories for rheumatology. Upon initial review, it appears the CMS has taken into account the concerns expressed by the ACR and other stakeholders about collapsing the evaluation and management (E/M) service codes.
Included in the rule are seemingly positive changes easing documentation burden, protecting reimbursement and recognizing the complexity of care provided by rheumatologists, as well as a delayed implementation date of 2021. Significantly, the CMS did not implement its proposed cuts to E/M visits furnished on the same day as a procedure. Several changes do seek to more immediately ease documentation burden beginning in 2019, which we will outline for members in coming weeks. We will have a more detailed update after we’ve had the opportunity to analyze all of the components of this modified final rule.
You can find updates about the ACR’s advocacy efforts, detailed analysis of CMS rules and other practice updates in our e-newsletter ACR@Work. In the meantime, refer to the following resources about how this rule may affect your practice:
- View the CY 2019 Physician Fee Schedule and Quality Payment Program final rule.
- The CY 2019 Physician Fee Schedule final rule fact sheet.
- The CY 2019 Quality Payment Program final rule fact sheet.
- E/M payment amount chart.
The ACR appreciates the significant advocacy work and engagement of individual members and volunteer leaders of the ACR/ARHP responding to the earlier proposal. It appears the CMS is listening and valuing input from the rheumatology community, and this outcome demonstrates the importance of advocacy efforts of the ACR and ACR/ARHP members. We will continue to work with the CMS and stakeholders on ways to make healthcare more accessible and affordable for the 54 million Americans living with rheumatic disease.