BEDFORD, MA--(Marketwired - Mar 21, 2017) - LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits nationwide, and has analyzed the implications of the Medicare 2017 Physician Fee Schedule and published its newest physician-focused Intelligence Briefing: 2017 Emergency Department Physician Update.
The Medicare 2017 Physician Fee Schedule final rule governs payment and other critical reimbursement issues, for dates of service beginning on January 1, 2017. The rule, published in the November 15, 2016 Federal Register, and the full 2017 Emergency Department Physician Update can be found on the LogixHealth website.
"MACRA has stabilized the conversion factor, provided for 0.5% increases and combines the quality programs of PQRS, the value modifier process, and meaningful use into a single new CMS quality payment program," says Elijah Berg, M.D., CEO of LogixHealth.
MACRA Legislation Eliminates the Sustainable Growth Rate Formula
With passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Medicare conversion factor has been stabilized and the previously looming large annual cuts have been retired. MACRA also provides for sweeping payment reforms and combines several previously disparate CMS quality programs under the Merit Based Incentive Payment System (MIPS).
2017 Conversion Factor
At the conclusion of 2016 the Medicare conversion factor (amount Medicare pays per RVU) was set at $35.8043. MACRA provides for annual conversion factor increases of 0.5% through 2019. However, several additional pieces of legislation mandate various degrees of cost savings resulting in a final 2017 conversion factor of $35.8887.
2017 RVUs for ED E/M Services
Each year, updated RVUs for physician services are published in the final rule. For 2017, RVUs for emergency medicine services remain unchanged. The RVUs associated with the ED E/M services 99281-99285 and 99291 will experience few changes with only critical care (CPT code 99291) experiencing a small increase from 6.31 to 6.32 RVUs.
New Merit Based Incentive Payment System (MIPS)
The three existing quality programs (PQRS, Value Modifier, and EHR) will be consolidated under the Merit-Based Incentive Payment System (MIPS), which will adjust payments based upon four performance categories:
- Resource use
- Clinical practice improvement activities
- Meaningful use of an electronic health record system
However, for this initial test year of 2017 data reporting, hospital based physicians will be scored primarily based on quality and improvement activities.
The MIPs program starts at +/-4% and increases by 2022 (based on 2020 performance) to +/-9%.
LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits nationwide. We provide tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.