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Research Outline
Prepared for Austin B. | Delivered November 6, 2019
Changes in 2020 Medicare Physician Fee Schedule and OPPS
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Goals
To understand the changes to the 2020 Medicare Physician Fee Schedule and the Outpatient Prospective Payment (OPPS).
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Early Findings
Physicians will see a virtually flat conversion factor, moving from
$36.04 to $36.09
.
There is an outpatient rule
2.6%
payment update for hospitals.
The highest
increases
in total allowed charges are clinical psychologist (3%), clinical social worker (3%) and neurology (2%). The biggest
decreases
are ophthalmology (-4%), diagnostic testing facility (-2%) and optometry (-2%).
T
h
e
schedule will also
include
the long-awaited "implementation of the long-awaited mandate requiring that clinicians consult appropriate use criteria through a qualified clinical decision support mechanism when ordering advanced imaging services."
CMS is now
transitioning
to reimbursement for principal care management instead of chronic care management.
The new OPPS strives to
increase choice
and encourage site neutrality.
"
Total Knee Arthroplasty
(TKA), Knee Mosaicplasty, six additional coronary intervention procedures, and twelve procedures with new CPT codes to the ASC CPL." have been added to the covered procedures list for ASCs.
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