Health Law Consulting Blog

Monday, January 27, 2014

Physician Payment Rates for 2014

The calendar year 2014 Physician Fee Schedule (PFS) proposed rule with comment period was placed on display at the Federal Register on July 8, 2013.  The final rule is on display at the Federal Register and will be published on December 10, 2013.

The 2014 physician payment rates increase payments for many medical specialties with some of the greatest increases going to providers of mental health services including psychiatry, clinical psychologists and clinical social workers. The final rule also includes several provisions regarding physician quality programs and the Physician Value-Based Payment Modifier (Value Modifier).  The Centers for Medicare and Medicaid Services (CMS) is also finalizing several related proposals to the Physician Quality Reporting System (PQRS) for 2014, including a new option for individual eligible professionals to report quality measures through qualified clinical data registries.

In 2014, quality measures will be aligned across quality reporting programs so that physicians and other eligible professionals may report a measure once to receive credit in all quality reporting programs in which that measure is used. Additionally, CMS is better aligning PQRS measures with the National Quality Strategy and meaningful use requirements, and transitioning away from process measures in favor of performance and outcome measures.  Requiring health care providers to focus attention to cost and quality is widely viewed as crucial to the United States reining in its healthcare spending and maintaining Medicare solvency.  

Significantly, the finalized physician payment rates and policies for 2014 include a major proposal to support care management outside the routine in-office interaction.  While the move to compensate physicians for care coordination services is a milestone that the CMS is applauded for in recognizing the significance of care that occurs outside of the traditional face-to-face encounters, the administrative burden issue remains a concern for many primary care physicians.

Beginning in 2015, CMS will offer separate payments for the management of a patient’s care outside of the face-to-face visit for those practices demonstrating the ability to provide such services. 

More to follow on this subject.


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