NCMS Morning Rounds 11-5-19

Physician Fee Schedule, Quality Payment Program Final Rule Released

On Friday, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) and Quality Payment Program (QPP) Final Rule. You can read the nearly 2500-page rule here, or get key takeaways through the Physician Fee Schedule Fact Sheet, and Quality Payment Program Fact Sheet.

A couple provisions of note (see the fact sheets for details), the new rule:

  • Updates regulation on physician supervision of physician assistants to give PAs greater flexibility to practice more broadly in the current health care system in accordance with state law.
  • Changes to the E/M documentation and coding framework used to bill Medicare for common office visits that will take effect Jan. 1, 2021.
  • Establishes a new Medicare Part B benefit for opioid use disorder treatment services, including medications for medication-assisted treatment (MAT). CMS is implementing this benefit beginning Jan. 1, 2020.
  • Streamlines the Quality Payment Program to reduce clinician burden.

To learn more about the PFS Final Rule and the 2020 Quality Payment Program finalized policies, review the following resources:

  • Press Release – includes more details about today’s announcement
  • Executive Summary – provides a high-level summary of the 2020 QPP final rule policies
  • Fact Sheet – offers an overview of the QPP policies for 2020 and compares these policies to the 2019 requirements
  • Frequently Asked Questions (FAQs) – addresses frequently asked questions about 2020 QPP final rule policies

CMS also encourages you to register for the 2020 Quality Payment Program Final Rule Webinar on Nov. 19 at 2 p.m.

For an outside CMS perspective read The Advisory Board Forum’s Our Take: How CMS Will Change Physician Payment in 2020. And watch your NCMS Morning Rounds for more detailed analysis in coming days.

PCPI Has Important Say in New Electronic Clinical Quality Measures

The PCPI Foundation, a national leader in clinician-level quality measurement and improvement, has received a Centers for Medicare and Medicaid Services (CMS) contract to play an important role in developing the next generation of electronic clinical quality measures. NCMS Senior Vice President for Health System Innovation and Deputy General Counsel Melanie Phelps, JD, serves on the PCPI Board of Directors.

The 5-year, $24 million agreement calls for developing, specifying and maintaining electronic clinical quality measures to be used for reporting by clinicians participating in Medicare, Medicaid and other CMS programs.

The measures form the basis of performance-based payment arrangements CMS uses to incentivize better care. More importantly, they will provide actionable clinical data for directly improving patient care and outcomes. The goal is to make measures that can rely on quality data that is collected as part of the routine delivery of care and as seamless as possible.

Learn more about the contract in this press release.

Appreciating Muslim Patients’ Cultural and Spiritual Influences

The Wake County Medical Society, the Wake County Medical Society Alliance and the Islamic Association of Raleigh has organized a  presentation entitled ‘What is Islam’ to promote dialogue and increased understanding of Muslim patients’ cultural practices and spiritual beliefs. The program, which will include a question and answer portion with the Islamic Association of Raleigh’s Imam Mohammed Abu Taleb, is based on the idea that a fuller understanding of a patient’s culture and beliefs better enables delivery of care as well as the individual’s satisfaction and health outcome.

If you are in the area on Sunday, Nov. 17 at 3 p.m., join your colleagues at the Islamic Association of Raleigh, 808 Atwater St. A light Middle Eastern meal will be served. Please RSVP by Nov. 15 to Zohra Osman at

In the News

CMS’ Final Outpatient, Physician Payment Rules for 2020: Nine Things to Know, Becker’s Hospital Review, 11-4-19

Learning Opportunity

The Centers for Medicare and Medicaid Services (CMS) is holding a call for Medicare Part B fee-for-service clinicians and office managers on the recently published physician fee schedule and OPPS/ASC final rules this Wednesday, Nov. 6 from 2:15 to 3:45 p.m. A question and answer session will follow the presentation. Learn more and register.




More Posts in MACRA


Share this Post