Back in July of 2018, CMS dropped some bombshells in its Medicare Physician Fee Schedule (MPFS) CY 2019 proposed rule. Due to overwhelming stakeholder feedback — much of it negative — the agency has resolved to implement the E/M updates over the course of two years, with only a few subtle modifications for CY 2019. Learn the ins and outs to the MPFS Final Rule and find out how it may affect your practice. During the webinar you’ll: Take charge and learn how CMS is helping reduce administrative burden on medical providers with their Patients Over Paperwork initiative Learn the requirements for medical decision making for home visits Gain helpful insight into documentation changes for E/M visits Get the inside scoop on how reimbursement may change for the future Nail down the changes to virtual care including virtual check-ins Highlight helpful tools and resources to help you keep track of all of the changes

1. Learn the Ins and Outs of the 2019 MPFS Final
Rule
Speaker: Nikki Taylor, MBA, CPC®, COC™, CPMA®, CRC™
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2. • Learn how CMSis helping reduce administrative burden
• Understand requirements for MDM for homevisits
• Gain helpful insight into E/M documentationchanges
• Get the inside scoop on how reimbursement may change for the
future
• Nail down the changesto virtual care including virtualcheck-ins
• Highlight helpful tools and resources tohelp you keep track of all of
the changes
Learning Objectives
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3. Proposed
Rule
• July12, 2018
Public
Comment
Period
• Ended
September
10, 2018
Final Rule
Published
• November 1,
2018
FinalRule
Effective
• January1,
2019
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2019 Medicare Physician Fee Schedule Timeline

4. • Physician burnout is anissue
• Most healthcareorganizations
• Impacts:
• Physicians
• Practice/organization
• Patients
• Clinicians may switch to administrative roles orleave
healthcare
• Removesthem from their “first love” treating patients
• Contributing factors for physicianburnout…
• Documentation requirements
• EHRtechnology
Patients Over Paperwork Initiative
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5. • Focuseson reducing administrative burden
• Improving carecoordination
• Health outcomes
• Patients’ ability to makedecisions
• Regulatory requirements and unnecessary paperwork steal time frompatient
care
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Patients Over Paperwork Initiative, cont.

6. • Changesto the Physician FeeScheduleaddressesthose problems
• Streamlines documentation requirements
• Brings focus back to patientcare
• Proposing to modernize paymentpolicies
• Medicare beneficiaries cantake advantage of the latesttechnologies
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Patients Over Paperwork Initiative, cont.

7. • Somedocumentation
requirements for homevisits
eliminated
• Would have to justifymedical
necessity
• Office visits are less expensiveto
the program
• Clinician can decide between an
office or homevisit
Shore Up Home Visit Documentation Requirements
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8. • Payment rates higher than office basedvisits
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Payment Rates for Home vs. Office Visits
Home visitcode 2019FeeSchedule Office visit code 2019FeeSchedule
99341 $56.22 99201 $46.49
99342 $81.09 99202 $77.48
99343 $132.26 99203 $109.92
99344 $185.24 99204 $166.86
99345 $225.24 99205 $209.75
99347 $56.22 99212 $45.77
99348 $85.41 99213 $75.32
99349 $131.18 99214 $110.28
99350 $182.00 99215 $147.76

9. • Documentation is critical for quality patientcare
• Medical record documentationreports:
• Patient carereceived
• Recordof
• Pertinent facts
• Findings
• Observations about health history
• Helps evaluate and plan treatment and monitorpatients
• Complaints—notes written to comply with coding requirementsDONOT
support patient care
Medical Record Documentation and Patient Care
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10. How itworks…
• Physiciansand other practitioners bill for office/outpatient E/Mvisits
using aset of CPTcodes
• Distinguish visits basedon:
• Levelof complexity
• Site of service
• New or established
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Levels of E/M Visits
https://www.supercoder.com/medical-
coding-webinars/ins-and-outs-of-the-2019-
medicare-physician-fee-schedule-final-rule

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12. Big Takeaways
• Patients Over Paperwork Initiative
• 2019 E/M documentation requirements have
changed
• Virtual care expanded with new andrevised
codes
• ESRDand Stroke care seechanges
• 2021 E/M coding, payment, and documentation
structure will change
• Changesto the Quality ImprovementProgram
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13. • https://www.cms.gov/About-CMS/Story-Page/CY-19-PFS-Final-Rule-
PPT.pdf
• www.supercoder.com
• https://cdn2.hubspot.net/hubfs/558940/Immunization%20Against%2
0Burnout.pdf?t=1525207992781
Resources
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https://www.supercoder.com/medical-
coding-webinars/ins-and-outs-of-the-2019-
medicare-physician-fee-schedule-final-rule