MPFS Payment and Policy Changes for 2018 Finalized


The Medicare Physician Fee Schedule for 2018 was finalized by the Centers for Medicare and Medicaid Services (CMS). Most notably, the payment and policy changes reflect a more lenient approach towards the adoption of federal policies.

Highlights of the MPFS Final Rule

The resource-based relative value scale (RBRVS) for 2018 is estimated at $35.9996 based on the 0.5 percent automatic adjustment under MACRA.

The number of measures to be reported under the PQRS incentive program has been reduced from nine to six. Further leniency has been allowed with no domain or cross-cutting requirements. These changes will make incentive payments more accessible to providers.

In addition, the CMS has postponed by one year the Appropriate Use Criteria, a requirement applicable to advanced diagnostic imaging services. This will now come into effect on January 1, 2020.

Finally, the CMS has made voluntary, for an unspecified length of time, the use of HCPCS Level II modifiers under MACRA as patient relationship codes.

Changes in the MPFS Final Rule

According to the American Society of Anesthesiologists, there are several changes in the codes for anesthesia services. For example, for intravascular catheterization, the work value has decreased. However, for percutaneous implantation of neurostimulator arrays, the work value has significantly increased. It is noteworthy that nurse anesthetists and assistants will bear a combined impact of negative 2 percent on permitted charges, making this category the most affected. The American Society of Echocardiography stated that for CPT code 93306, the increase in RVUs from 1.30 to 1.50 is a welcome change.


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