Anesthesia & pain management – CMS’s 2019 proposed payment rule: 6 key points

CMS’s 2019 proposed payment ruleThe CMS’ proposed Medicare Physician Fee Schedule for 2019 includes changes to the quality payment program and a slight increase in the anesthesia conversion factor.

Here’s what you need to know:

  1. The national conversion factor for anesthesia services will see an increase from $22.1887 to $22.2986. The increase includes the 0.25 percent positive and budget neutrality adjustments mandated by the Bipartisan Budget Act of 2018.
  2. The proposed resource-based relative value scale CF (non-anesthesia) of $36.043 for 2019 increased from the current rate at $35.996. Anesthesiologists would use this conversion factor to bill for flat fee services, like the use of ultrasound guidance in the placement of a nerve block.
  3. Changes to the quality payment program and evaluation and management services streamline documentation requirements, allowing clinicians to “to put patients over paperwork,” according to CMS Administrator Seema Verma.
  4. Proposed evaluation and management documentation requirements changes include expanding current options to allow clinicians to document and bill for evaluation and management services based on time, as well as the elimination of a policy preventing payment for same-day evaluation and management visits by multiple practitioners in the same specialty.
  5. Changes to the quality payment program include expanding the low-volume threshold criteria to give more clinicians the option not to participate in the merit-based incentive payment system and allowing facility-based clinicians to use the measure set for the hospital value-based purchasing program for their quality and cost scores.
  6. CMS is accepting comments on the proposal until Sept. 10.

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