HIMSS News

CMS Finalizes 2019 Medicare Physician Fee Schedule and Quality Payment Program Rule

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On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) finalized its rule for the 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP). CMS states that this rule will modernize Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services no matter where they live.

Overall, CMS finalized several health IT-related provisions, including measures to pay separately for two newly-defined physicians’ services furnished using communication technology: brief virtual check-ins between clinicians and Medicare beneficiaries; and, remote evaluation of recorded video and/or images submitted to a clinician by an established patient. CMS is also promulgating final policies for Year 3 of QPP that advance CMS’ Meaningful Measures initiative and seek to reduce clinician burden, while focusing on patient outcomes and promoting interoperability between clinicians and beneficiaries.

In terms of alleviating clinician burden, the Final Rule also implements several new evaluation and management (E/M) documentation requirements, including allowing clinicians to focus their documentation on what has changed since the last visit (or on pertinent items that have not changed) for established patient office/outpatient visits, when relevant information is already contained in the electronic health record.

HIMSS will continue to provide updates and additional resources on this final rule.

CMS created a fact sheet on the 2019 Physician Fee Schedule piece of the proposed rule as well as a separate fact sheet on the 2019 Quality Payment Program piece of the final rule.