Reimbursement

Medicare Issues Final 2020 Physician Payment Policies

September 11, 2019


Medicare Issues Final 2020 Physician Payment Policies

 

The Centers for Medicare & Medicaid Services (CMS) has issued the final Medicare payment and policy rule for the 2020 physician fee schedule, which goes into effect January 1.

Highlights:

  • Bundled Payment: CMS finalized a monthly bundled payment for managing and counseling opioid use disorder. It covers overall management, care coordination, individual and group psychology, and substance-use counseling.
  • Telehealth: CMS added several codes to the list of telehealth services to allow providers to use telehealth in providing care management and counseling in the opioid payment bundle. CMS says telehealth will increase access for beneficiaries, especially in rural areas or those with a shortage of clinicians.
  • Care Management: CMS increased payment for the time clinicians spend on care management for various types of chronically ill patients: those transitioning from the hospital to their homes; those with a single, high-risk chronic condition, such as diabetes; or those who have multiple chronic conditions.
  • Pay-for-Performance: CMS simplified the way clinicians can participate in the Merit-Based Incentive Payment program (MIPS)—one of the main methods CMS uses in updating physician payment based on the clinician’s quality performance. CMS will allow physicians, starting in 2021, to report their performance on a smaller set of measures that are specialty-specific and outcomes-based.