On November 2, CMS issued the 2018 Physician Fee Schedule (PFS) Final Rule that goes into effect on January 1, 2018. The Final Rule contains updates to payment rates and payment policies as well as updates to quality provisions for services provided under the Medicare Physician Fee Schedule.
One of the biggest questions from the Proposed Rule was whether there would be major changes to the evaluation and management (E/M) services guidelines. In the Proposed Rule, CMS sought comments regarding the removal of the history and exam documentation requirements and revision of the guidelines to base code selection on medical-decision-making and time because CMS indicated they believe these are the more significant factors in determining the level of service to be billed. The Final Rule does not reflect any changes to the physician E/M codes for 2018. However, CMS will continue to review the comments and suggestions and collaborate with stakeholders prior to implementing any changes.
As usual, there are many payment, coding and coverage revisions outlined in the Final Rule including radiology advanced imaging, chronic care and PQRS. We recommend providers review the entire Final Rule and make internal updates and changes as applicable.
The 2018 Physician Fee Schedule Final Rule can be found at: