Medicare Physician Fee Schedule(MPFS) using the RBRVS (Resource Based Relative Value Scale) as the main vehicle for implementing the fee schedule. Each year CMS proposes changes to MPFS and then at the beginning of the calendar year implements the changes.
Session Objectives:
To briefly review the main components of MPFS.
To discuss the broad range of changes being made to MPFS including technical RVU changes as well as policy changes.
To understand the changes in E/M payment and documentation requirements for CY2021.
To appreciate the changes being made relative to the Sustainable Growth Rate (SGR), such as MIPS and APM incentives.
To review proposed changes in the RVUs for selected physician specialties.
To briefly review changes in CPT and HCPCs coding.
To discuss the proposed change in the Global Surgical Package (GSP),
To briefly discuss associated policy areas such as physician quality reporting and the physician compare website.
To review changes in associated payment systems and services such as telehealth, anesthesia and the ambulance fee schedule (AFS).
To discuss non-physician practitioners (NPPs) special changes that are being made relative to NPPs.
To review the possible impact of the proposed changes on different specialty areas.
To discuss related issues such a provider-based clinics and special services such as observation services.
Session Agenda:
Review of MPFS and RBRVS
Use of Relative Value Unit
Work Component
Practice Expense Component
Malpractice Component
Conversion Factor and SGR
Updating of RVUs
Geographic Adjustments for MPFS
Non-Physician Practitioner Involvement
Major Policy Areas for the MPFS
Other Areas Affected by the MPFS
Review Code Set Changes
CPT
HCPCS
EM Payment and Documentation Changes for CY2021
Changes Being Made to MPFS/RBRVS for CY2019
RVU Changes
Conversion Factor and SGR
Site-of-Service Consideration
Changes in GPCIs
Facility vs. Non-Facility Practice Expense RVUs
Radiation Oncology
Future Changes and Trends
Global Service Changes(GSP)
GSP Basics
Problem Areas for Physicians to Report Correctly
Discontinuing 10-Day and 90-Day Global Periods
Possibly Impacts on Physicians and Clinics
Commenting to the Proposed Changes
MACRA 2015
MIPS – Merit-Based Incentive Payment System
APM – Alternative Payment Model
Timing of Changes
Payment Impacts
Associated Areas of Concern
Ambulance Fee Schedule
Anesthesia Fee Schedule
Telehealth
Non-Physician Practitioner
Health Information Technology
Physician Quality Reporting
Provider-Based Clinics
The Future of MPFS and RBRVS