CMS announced Thursday that many of the proposed changes will be in effect next year and into 2021. In 2019 providers can look forward to less documentation standards for data already contained in the patient record. In a shift from the accept guidelines from 1997, Medicare providers can now review info already in the patient’s record and only indicate changes. No more redundant entering of data into the EHR encounter.
In 2021, CMS will adopt a new office visit coding method. The current E/M (“99 codes”) levels will be replaced with one for levels 2-4 while keeping the level 5 code for complex visits. Payment will be slightly higher than a level 3 but lower than a level 4. Special “add on codes” for glaucoma screening of high-risk patients will be allowed as well as prolonged service codes 99354-99357 when time exceeds 34 minutes for an established visit and 38 minutes for a new.
Some of the details of the proposals are still being worked out like “virtual check ins” but the final rule signals a resolve to reduce administrative and patient encounter time for Medicare physicians.
For MIPS, providers who bill less than the threshold of Medicare may now “opt in” to the program for 2019 and try to qualify for bonuses. The Medicare Quality Payment Program is also looking to reduce the amount of measures used an increase the qualifying scores. MIPS is moving providers toward “interoperability” among EHR systems and better use of Health Information Exchange Systems to co-manage patients.