Medicare’s 2019 Physician Fee Schedule and Quality Payment Program Proposal Released

The Centers for Medicare and Medicaid Services (CMS) released the calendar year 2019 payment rule for the Medicare Physician Fee Schedule (PFS) and Quality Payment Program for MACRA on July 13, 2018. Comments are due on September 10, 2018.

TOA’s members are invited to review TOA’s analysis of the proposal, which can be found in the e-mail newsletter or by visiting the website.

The following proposals relate to orthopaedics in the proposal:

  • Patient-reported outcomes for MIPS.
  • Checking the state’s prescription monitoring drug program (PDMP) database for MIPS.
  • Adding physical therapy to MIPS.
  • CMS believes that it will save the average physician 51 hours a year due to the new E/M proposal.
  • A small payment for “virtual visits” prior to an office visit.
  • Global data collection and its future. Hint: 90-day payments are big in orthopaedics.
  • Physician employment: Hospitals remain unhappy.