CMS Physician Fee Schedule Proposed Policy, Payment, and Quality Provisions Changes for CY 2020

On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2020. This proposed rule is one of several proposed rules that reflect a broader Administration-wide strategy to create a health care system that results in better accessibility, quality, affordability, empowerment, and innovation. It also includes proposals to streamline the Quality Payment Program with the goal of reducing clinician burden. This includes a new, simple way for clinicians to participate in our pay-for-performance program, the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways.

The proposed rule also includes:

CY 2020 PFS rate setting and conversion factor
Medicare telehealth services
Payment for evaluation and management services
Physician supervision requirements for physician assistants
Review and verification of medical record documentation
Care management services
Comment solicitation on opportunities for bundled payments
Medicare coverage for opioid use disorder treatment services furnished by opioid treatment programs
Bundled payments for substance use disorders
Therapy services
Ambulance services
Ground ambulance data collection system
Open Payments Program
Medicare Shared Savings Program
Stark advisory opinion process