On July 29, CMS issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2020. This proposed rule is one of several proposed rules that reflect a broader Administration-wide strategy to create a health care system that results in better accessibility, quality, affordability, empowerment, and innovation. It also includes proposals to streamline the Quality Payment Program with the goal of reducing clinician burden. This includes a new, simple way for clinicians to participate in our pay-for-performance program, the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways.

The proposed rule also includes:

  • CY 2020 PFS rate-setting and conversion factor
  • Medicare telehealth services
  • Payment for evaluation and management services
  • Physician supervision requirements for physician assistants
  • Review and verification of medical record documentation
  • Care management services
  • Comment solicitation on opportunities for bundled payments
  • Medicare coverage for opioid use disorder treatment services furnished by opioid treatment programs
  • Bundled payments for substance use disorders
  • Therapy services
  • Ambulance services
  • Ground ambulance data collection system
  • Open Payments Program
  • Medicare Shared Savings Program
  • Stark advisory opinion process

For More information:

See the full text of this excerpted Fact Sheet (Issued July 29).