LogixHealth Releases Review of 2020 Physician Fee Schedule Final Rule

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Feb 06, 2020, 08:46 ET

BEDFORD, Mass., Feb. 6, 2020 /PRNewswire/ -- LogixHealth has released its 2020 Emergency Department Physician Update, a comprehensive review of Medicare's 2020 Physician Fee Schedule Final Rule.

According to LogixHealth's 2020 Emergency Department Physician Update, the 2020 rule continues to no longer be governed by the Sustainable Growth Rate (SGR) formula, which had mandated annual cuts to physician payments, resulting in year-after-year eleventh-hour congressional rescues with short-term fixes. Instead, with the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), 2020 represents the fourth year of a stabilized conversion factor.

At the conclusion of 2019, the Medicare conversion factor (the amount Medicare pays per RVU) was set at $36.0391. MACRA previously provided for annual conversion factor payment increases of 0.5% through 2019 which have now ended, and we have entered a period of 0.0% updates. After accounting for several technical adjustments, the 2020 final rule published a conversion factor of $36.0896.

In 2018, CMS recommended that the American Medical Association's Relative Value Update Committee (RUC) survey and potentially revalue the work RVUs associated with the emergency department (ED) evaluation and management (E/M) CPT codes (99281-99285) citing that they are potentially undervalued. The RUC completed its survey, CMS accepted the RUC's recommendations and the 2020 Physician Fee Schedule Final Rule reflects updated RVUs for the ED E/M services. For 2020, the work RVUs for emergency medicine services have increased. The total RVUs associated with ED E/M services 99281-99285 are also going up.

According to Elijah Berg, M.D., CEO of LogixHealth, CMS has accepted the AMA's RUC recommendations to increase the work RVUs for ED E/M services, which is great news for emergency physicians, "The CMS specialty-specific impact analysis states that emergency medicine will experience a 1% update in overall Medicare reimbursement for 2020," states Dr. Berg.

Also of interest, the Merit-Based Incentive Payment System (MIPS) is a payment mechanism that provides for annual reimbursement adjustments related to quality program requirements impacting 2022 payments based on 2020 reporting in four categories; Quality, Cost, Improvement Activities, and Promoting Interoperability. For the 2020 performance year (impacting 2022 payments), the four MIPS categories will be consolidated for most emergency physicians to include: 70% Quality (the old PQRS program), 15% Cost, and 15% Improvement Activities. LogixHealth's 2020 Emergency Department Physician Update newsletter includes further detail outlining the payment program.

LogixHealth's 2020 Emergency Department Physician Update and Medicare's 2020 Physician Fee Schedule Final Rule can be found on the LogixHealth website: www.logixhealth.com.

About LogixHealth
LogixHealth provides expert coding, billing, data insights, and technology solutions for top hospitals, emergency departments and office-based practices nationwide, servicing millions of patient visits annually across over 40 states. LogixHealth offers the tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.

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