ACP is urging all of its members to actively engage with Congress in our effort to protect much-needed gains for primary and cognitive care that were included in the final physician fee schedule regulations. As announced on Nov. 1, the Centers for Medicare and Medicaid Services (CMS) finalized regulations that will go into effect in 2021 to greatly improve payments for your undervalued Evaluation and Management (E/M) services and reduce the time you must spend on unnecessary documentation. Yet efforts are being made by some physician specialties to persuade Congress to block these improvements for E/M services; it's imperative that they not succeed. We urgently need your help in reaching out to your members of Congress to urge them instead to support CMS's improvements in E/M payment and documentation.
Here's the back story. Last year, CMS decided it would pay the same flat amount for office visits levels 2 through 4, regardless of complexity, devaluing complex cognitive care. Now, in direct response to ACP advocacy, CMS has reversed itself and decided it will continue to pay appropriately more for each level of visit complexity rather than one combined flat fee. Even better, as ACP recommended, CMS agreed to increase overall payments for each office visit code, while reducing required documentation of them. We applaud CMS for having adopted so many of ACP's recommendations (see more information below) in the final regulations.
On November 6, 2019, ACP sent a letter to the leaders of the key congressional health care committees urging that they express their support to CMS for full implementation of the final regulations. ACP has decided to pro-actively take that step in reaching out to Congress because grassroots efforts on the part of some specialty organizations are underway to block, delay, or undermine the improvements in payments and documentation for office visits, to the detriment of internal medicine physicians, family physicians, other cognitive and primary care physicians-and most importantly, your patients. Now is not the time to be complacent but rather we must advocate vigorously to ensure that the final regulations are implemented.
Action Requested: Please send a letter to your members of Congress in both chambers urging them to advocate with CMS in support of full implementation of the 2020 physician fee schedule regulations. A sample letter has been provided for you that you can personalize. Using the "Take Action" link below, simply fill in your contact information, follow the prompts, and submit your letters electronically.
Background: Major advocacy "wins" in the 2020 final physician fee schedule regulations include:
- Higher physician work RVUs for new and established office visit codes, leading to increased payments for them. The higher work RVUs are essential and based on evidence that shows that current payment levels undervalue the complexity of physician work in providing primary and cognitive care to patients.
- Reduced documentation requirements for office visit codes, which enables physicians to select and document for each visit based on medical decision-making or total time. These changes will allow physicians to spend more time with patients and less on documentation and paperwork.
Expanded and improved payment for care management services. Appropriate payment for care management will make it possible for physicians to coordinate care with others on the patient's clinical care team, leading to better health outcomes.