Medicare

Medicare E/M proposal will slash physicians’ documentation load

What’s the news: New proposals that prioritize patients over paperwork and let doctors be doctors by reducing administrative burdens—including simplifying coding for evaluation-and-management (E/M) office visit services—were released this week by the Centers for Medicare & Medicaid Services (CMS).

The burden-reducing rules were included in the proposed 2020 Medicare physician payment schedule. Earlier this year, the AMA-convened Current Procedural Terminology (CPT®) Editorial Panel approved revisions to the CPT E/M visit reporting guidelines and code descriptors.

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The AMA is still reviewing the 1,700-page 2020 fee schedule, but the proposed revisions for reducing E/M reporting burdens deserve praise.

“The AMA stands ready to help the entire health care community implement the simplified approach to E/M documentation and coding and has created a website that provides useful background and instructional information,” said AMA President Patrice A. Harris, MD, MA.

Why it matters to patients and physicians: CMS said it is “investing in the critical thinking required to evaluate a patient,” which will improve outcomes—especially for the one in five Medicare beneficiaries with multiple chronic conditions such as diabetes and hypertension.

The proposal shows the powerful impact of AMA advocacy efforts and collaboration with CMS to recognize the value of time spent coordinating patient care. Dr. Harris noted that the proposed changes to E/M documentation and coding were “developed in partnership between the AMA and CMS and with broad input from the medical community.”

The CMS proposal to accept the CPT Panel alternative and recommendations from the AMA/Specialty Society RVS Update Committee (RUC) “reflects the increasing complexity of these services and the resources required to provide them, and represents a significant step toward reducing administrative and documentation burdens in medicine,” Dr. Harris added.

The proposed CPT changes would:

  • Streamline requirements for reporting office visits.
  • Reduce the “note bloat” that leads to verbose, redundant and hard-to-navigate patient progress notes.
  • Improve workflow and contribute to a better environment for health professionals and their Medicare patients.

What’s next: Comments on the proposed rule are due Sept. 27, and the AMA is studying the entirety of the Medicare physician payment schedule and preparing to weigh in.

“While the AMA continues to assess the full scope of the proposed Medicare payment schedule rule, we are pleased to see important policy revisions that will bring us closer to a more patient-centered health care system that promotes the key principles of affordability, accessibility, quality and innovation,” Dr. Harris said. “The AMA looks forward to further collaboration with CMS as we work toward the shared goal of providing high-value care for patients.”

The AMA is hard at work developing educational materials to describe the revised CPT office visit codes and documentation guidelines, which are designed to reduce administrative burdens. Subscribe now to stay in the loop on the latest updates of the AMA’s ongoing CPT work.