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AMA responds to final Medicare fee schedule rule

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Nov. 1 (AMA) -- According to Ardis D. Hoven, M.D. AMA President-elect, "The American Medical Association (AMA) is pleased that CMS included some of our key recommendations in the final Medicare fee schedule rule, including adopting the CPT codes for transitional care management and increasing the size of groups that will be affected by the initial value-based modifier policy.

"In response to strong recommendations from a joint AMA workgroup of CPT Editorial Panel and RUC members, CMS will implement RUC recommendations and payment for new transitional care management services reported by new CPT codes 99495 and 99496. The AMA appreciates that CMS recognizes the value of these services for improving the overall quality of health, as this rule supports physicians working in emerging models of care and the work involved in transitioning patients from one care setting to the next.

"For physicians participating in the Medicare e-prescribing program, CMS has added an appeals process and two additional penalty exemptions for physicians who are participating in the meaningful use electronic health records program.

“The release of the Medicare physician fee schedule rule reminds patients, physicians and Congress that the time to act to prevent looming Medicare cuts is now. Without quick Congressional action, physicians who care for Medicare patients will be hit with a 26.5 percent cut in payments on January 1 due to the flawed Medicare physician payment formula. Eliminating this failed formula will allow us to enter a period when physicians can begin transitioning to new payment and delivery models to help meet the overall goal of improving patient care and moving to a higher performing Medicare program. We look forward to fully reviewing the rule in more detail.”


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