Sep 12, 2018

Doctors hate Medicare's proposed billing changes

A neurologist meets with a Medicare patient. Photo: Nicholas Kamm/AFP via Getty Images

Physicians have inundated the Centers for Medicare & Medicaid Services with comments in a bid to kill a major change to how they would get paid for routine patient visits.

Where it stands: Medicare wants to create a new, fixed payment rate next year for all office visits, regardless of how much time physicians spend with the patient or how sick the patient is.

  • For most new patients, doctors would get paid $135 for an office visit (compared with the current range of $76-$211, depending on the visit’s medical code).
  • For returning patients, doctors would get paid $93 (compared with the current range of $45-$148).
  • Some codes could be added to account for complex visits.

What they're saying: Pretty much every state and national physician group (including the American Medical Association) hates the proposal and wants it dead. Doctors who would lose the most money, such as oncologists and neurologists, were the most vocal.

Between the lines: CMS has wanted to change payments to office visits for many years now, citing how they are prone to fraud and abuse. This proposal would benefit some doctors at the expense of others (welcome again to the world of trade-offs). Don't be surprised if Medicare officials spike the proposal when a final rule comes out in November, given the huge backlash.

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