Nov 2, 2018

Medicare hedges on billing rules

Seema Verma, Administrator of the Centers for Medicare and Medicaid Services. Photo: Kate Patterson/The Washington Post via Getty Images

Physicians were furious earlier this year when Medicare proposed consolidating most billing codes for routine office visits into a single code next year. Medicare now says it won’t go that far or that quickly, but it will move forward with the general idea.

Why it matters: This affects billions of dollars in physicians' pay.

Driving the news: The Centers for Medicare & Medicaid Services said in a 2,378-page final rule yesterday that instead of collapsing 4 office visit codes into 1, it will collapse 3 codes into 1, and keep the highest-paying code.

  • Doctors would get paid $130 for most new patient visits and $212 for the most complex new patient visits.
  • Doctors would get paid $90 for returning patient visits and $149 for the most complex returning patient visits.
  • Those rates could be higher if doctors attach a special “add-on” code.
  • However, this will not go into effect until 2021 — giving doctors 2 years to ease into — or try to kill — the new rules.
  • When asked whether the agency would consider scrapping the rule before it goes into effect, CMS Administrator Seema Verma told reporters in a conference call: “No.”

The big question: It’s unclear whether the rule will address concerns of fraudulent billing, because the most lucrative code will still exist.

Go deeper

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 1 p.m. ET: 622,450 — Total deaths: 28,794 — Total recoveries: 135,779.
  2. U.S.: Leads the world in cases. Total confirmed cases as of 11 a.m. ET: 105,573 — Total deaths: 1,711 — Total recoveries: 895.
  3. Federal government latest: President Trump is reportedly considering a quarantine on New York, parts of New Jersey and Connecticut. He signed the $2 trillion coronavirus stimulus bill to provide businesses and U.S. workers economic relief.
  4. State updates: A group of Midwestern swing voters that supported President Trump's handling of the coronavirus less than two weeks ago is balking at his call for the U.S. to be "opened up" by Easter. Alaska is latest state to issue stay-at-home order — New York is trying to nearly triple its hospital capacity in less than a month.
  5. World updates: Italy reported 969 coronavirus deaths on Friday, the country's deadliest day. In Spain, over 1,300 people were confirmed dead between Thursday to Saturday.
  6. 🚀 Space updates: OneWeb filed for bankruptcy amid the novel coronavirus pandemic.
  7. What should I do? Answers about the virus from Axios expertsWhat to know about social distancing.
  8. Other resources: CDC on how to avoid the virus, what to do if you get it.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

Trump weighs quarantine of New York, New Jersey and Connecticut

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios

President Trump said on Saturday he is considering a "short term" quarantine of New York, New Jersey and parts of Connecticut — areas congruent with the New York metro area. The White House has advised those who travel from the metro area to self-quarantine for 14 days.

The big picture: With 105,000 people infected, the U.S. has the most COVID-19 cases in the world, exceeding China and Italy, per data from Johns Hopkins. A second wave of American cities, including Boston, Detroit, New Orleans and Philadelphia, are reporting influxes of cases.

Go deeperArrowUpdated 34 mins ago - Health

How the war on disease made our world

Illustration: Sarah Grillo/Axios

The biggest pandemic in decades serves as a reminder of just how big a role infectious disease has played in human history — and will continue to play in the future.

The big picture: Without victory over infection, humanity wouldn't have developed the globalized and populous civilization of today. Yet that civilization is vulnerable to COVID-19, which can only be fought by decoupling the connections that underpin the modern world.

Go deeperArrow42 mins ago - Health