CHA News Article

Physician Fee Schedule Proposed Rule Expands Telemedicine Services, Updates ACO Program

The Centers for Medicare & Medicaid Services (CMS) has released the attached proposed rule updating the physician fee schedule (PFS) for calendar year 2015. The proposed rule provides details on a policy finalized last year for a separate payment outside of a face-to-face visit for managing the care of Medicare patients with two or more chronic conditions, beginning in 2015. CMS also proposes a new process for establishing PFS payment rates, requiring payment changes to undergo notice and comment rulemaking before being adopted for 2016.

In addition, the PFS proposed rule includes provisions updating the number of quality measures used in the Medicare Shared Savings Program for accountable care organizations (ACOs). Specifically, the number of quality measures used to assess ACOs would increase from 33 to 37, and ACOs would need to meet the quality performance goals to earn bonus payments under the program. CMS also proposes changes to the physician quality reporting systems and expands telemedicine payments for annual wellness visits, psychoanalysis, psychotherapy and prolonged evaluation and management services. CMS notes that the proposed rule does not take into account the sustainable growth rate, which – if not delayed or repealed by Congress by March 31, 2015 – would result in a 20.9 percent payment reduction to physicians. Comments on the proposed rule are due by Sept. 2.