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Medicare Begins Paying Primary Care Docs for Care Coordination

An AP wire covers this development in Medicare reimbursement.

Starting this month, Medicare will pay primary care doctors a monthly fee to better coordinate care for the most vulnerable seniors -- those with multiple chronic illnesses -- even if they don't have a face-to-face exam.

The change was part of the final rule for the 2014 Medicare physician fee schedule issued in December 2013. Although supported in the physician community when first announced, the general reaction seemed to be that the amount offered - - about $40 per month - - was only halfway reasonable, as an article at MedPage suggested.

Here's a snippet from the Final Rule for the 2014 fee schedule, discussing the proposal:

[W]e believe that the resources required to furnish chronic care management services to beneficiaries with multiple (that is, two or more) chronic conditions are not adequately reflected in the existing E/M codes. Therefore, for CY 2015, we proposed to establish a separate payment under the PFS for chronic care management services furnished to patients with multiple chronic conditions that are expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

We also stated our intent to develop standards for furnishing
chronic care management services to ensure that the physicians and practitioners who bill for these services have the capability to provide them.

See 78 Fed. Reg. 74415 (Dec. 10, 2013). See also 79 Fed. Reg. 40364 (July 11, 2014).

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This page contains a single entry from the blog posted on January 14, 2015 11:08 AM.

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