“The ACR has asked the Committee on Ways and Means to correct this problem by clarifying to CMS that only reimbursement from physician services should be adjusted in MIPS,” he says.
Needed: New E/M Clinical Billing Codes
Another issue highlighted by both Drs. Worthing and Laing is the importance for the CMS to come up with new E/M clinical billing codes that value the cognitive care that rheumatologists routinely provide to their patients. In an Aug. 25 letter to the Committee on Ways and Means, Subcommittee on Health, regarding statutory and regulatory burdens on optimized efficiency and patient care, the ACR highlighted that current definitions and valuations of these services remain deficient and have resulted in creating workforce shortages and burdening Medicare beneficiaries.
Dr. Worthing emphasized the need for new billing codes that better represent the value cognitive care confers to patients by helping save time, reduce diagnostic testing and prevent long-term disability by allowing disease-modifying therapy to be started before joint damage can begin.
Dr. Laing says he’s heard that the CMS is interested in making changes to the billing code for these services. “This potentially will have a huge effect on the practice of rheumatology, because so much of what we do is so-called cognitive work or evaluation-type management work. If CMS follows through with [making these changes] and we do evolve to a much simpler coding scheme for those kinds of services, that would be a really big plus for rheumatology.”
Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.
