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2019 Medicare Physician Fee Schedule Proposal

November 15, 2018
Expert Analysis of 2019 Physician Fee Schedule Now Posted
Hart Health Services has completed their expert analysis of the Final 2019 Physician Fee Schedule. Read a high level summary of key points here. To compare the Final 2019 Physician Fee Schedule with the earlier fee schedule proposed by the Centers for Medicare and Medicaid Services (CMS), click here. To review and compare 2018 and 2019 CMS reimbursement rates for relevant Current Procedural Terminology® (CPT) codes, click here.

For the practicing allergist/immunologists, highlights of the Final 2019 Physician Fee Schedule include:
• For Calendar Year (CY) 2021, CMS is collapsing the payment variation for E/M office/outpatient visit levels by paying a single rate for E/M office/outpatient visit levels 2 through 4 for established and new patients, and is maintaining the payment rate for E/M office/outpatient visit level 5 to better account for the care and needs of complex patients. CMS estimates that the impact of the cumulative finalized policies will, on the whole, be cost-neutral.
• The national reimbursement rate for CPT 95165 (Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens) increased from $13.31 in CY 2018 to $14.41 in CY 2019.
• The CY Physician Fee Schedule conversion factor is 36.0391, a +0.11 percent increase over CY 2018.

For more information on how conversion factor, practice expense and RVU factors combine to determine reimbursement rates, click here.

September 20, 2018
A bi-partisan group of Senators sent a letter today to CMS regarding the proposal to collapse E & M codes in the Medicare Physician Fee Schedule. The letter expresses concern about the impact on vulnerable patients with complex conditions and urges CMS to work collaboratively and with transparency with other stakeholders to explore alternatives to reduce physician burden while improving healthcare quality. The AAAAI is part of the coalition that secured this letter.

September 10, 2018

In response to the 2019 Proposed Medicare Physician Fee Schedule, the AAAAI expressed deep concern regarding the CMS’ proposed collapse of E/M services (Level 2-5); and urged CMS to reconsider Venom Immunotherapy and Antigen Costs, while also commenting upon the Quality Payment Program, and other aspects of the proposal.

To review the AAAAI letter, click here.

To review the letter co-signed with the American College of Allergy, Asthma & Immunology, the Advocacy Council of the American College of Allergy, Asthma & Immunology and American Academy of Otolaryngic Allergy, click here.

The Patient-Centered Evaluation and Management Services Coalition (Coalition), of which the AAAAI is a part, wrote to share concerns with the new evaluation and management (E/M) coding and payment proposals included in the Medicare Physician Fee Schedule Proposed Rule for Calendar Year 2019 (Rule). Read the letter to Members of Congress here. Read the letter to the Administration here.

September 7, 2018

Read the “Dear Colleague” letter written with the support of a coalition of specialty societies concerned about the implications of the E&M proposal on both patient access and physician reimbursement. The AAAAI is a member of the coalition that secured this letter.