medIcare-1Healthcare professionals have embraced the evaluation and management (E/M) documentation changes being proposed by CMS aimed at reducing administrative responsibilities while streamlining Medicare billing. Organizations such as the American Medical Association praised CMS for the proposed changes to the documentation necessary for a patient’s history. With these proposed changes, E/M documentation would concentrate solely on interval history since a patient’s last visit.

Other E/M documentation changes were also met with approval including removing the need for physicians to re-document existing information in a patient’s record by practice staff or the patient himself as well as removing the need to provide justification for a home versus office visit.

While all of these proposals have been met with a positive response, not everything in the 2019 Medicare Physician Fee Schedule rule has received quite as warm a welcome. Questions have been raised regarding the proposed reduction in the number of payment rates for eight office visit services for new and current patients down to two each.

CMS has proposed a payment policy that would create individual blended payment rates for new and current patients for office/outpatient E/M levels two to five visits. The payment policy would also produce add-on codes to resolve the resources utilized in delivering primary care and non-procedural specialty generally recognized services.

With the proposed payment policy for E/M visits, CMS seeks to create better Medicare reimbursement accuracy while streamlining medical billing documentation. However, those that are wary of the payment changes suggest it may harm providers and other healthcare professionals that are treating especially sick patients and those delivering comprehensive primary care.

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