CMS releases proposed 2015 Medicare physician fee schedule
The Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule (PFS) rule for 2015. CMS will accept public comments on the rule until Sept. 2, 2014 and intends to issue the final 2015 PFS by Nov.1, 2014.
The proposed rule:
- Sets 2015 Medicare payment rates for physician services and anticipates a negative 20.9% update due to the sustainable growth rate formula following expiration of the Protecting Access to Medicare Act on March 1, 2015 without congressional intervention
- Adjusts malpractice RVUs as part of a required five-year review
- Continues implementation of the value-based payment modifier (VBPM) by applying the 2017 VBPM to solo practitioners and all physicians and nonphysician eligible professionals (EPs) in groups with two or more EPs. CMS increases the maximum amount of payment risk under the VBPM from 2% in 2016 to 4% in 2017. The 2017 VBPM is based on 2015 performance.
- Outlines criteria for avoiding 2017 Physician Quality Reporting System (PQRS) penalties, which will be based on 2015 performance. The bonus phase of this program ends in 2014 but penalties continue into the future.
- Establishes a separate payment beginning in 2015 for chronic care management services
- Increases the amount of information about physicians and practices on the Physician Compare website, including information pertaining to quality measure performance
- Modifies the Medicare Shared Savings ACO Program (MSSP), including adjustments to MSSP quality reporting and, beginning in 2017, applying the VBPM to EPs in Medicare ACOs
Visit the Federal Register to view the full proposed 2015 Medicare physician fee schedule. CMS has also posted several fact sheets, including one on proposed policy and payment changes, another on changes to physician quality reporting programs and a third on changes to the value-based payment modifier.
In a separate rule, CMS proposed changes to policies and payments regarding hospital outpatient and ambulatory surgical centers.
