Action Alert! Comment on E/M Code Discrimination | News | APMA
Action Alert! Comment on E/M Code Discrimination

July 30, 2018

Act Now

On July 12, CMS released a proposed rule [CMS-1693-P] that, if finalized, would require podiatrists to use different E/M codes from all other Medicare physicians. The codes would reimburse at a significantly lower rate.

Write to CMS and Oppose Unfair and Discriminatory Proposed Rule

Proposed Rule

In an attempt to reduce physician burden, CMS is proposing to reform documentation requirements for E/M services in the following manner:

  1. First, CMS would consolidate reimbursement for office-based and outpatient E/M visit levels 2 through 5 (i.e., CPT codes 99202 through 99205 for new patients and CPT codes 99212 through 99215 for established patients) into a singular flat rate payment for new patients and established patients, respectively, regardless of which code is billed. Documentation requirements would be the same as they currently are for level 2 codes (99202 or 99212, as applicable).
  2. Second, while these payment changes would apply to all other Medicare physicians, CMS has singled out podiatric physicians with new separate “podiatric E/M codes.” These codes would require the same documentation and reimburse at a significantly lower rate, despite being the same evaluation and management services that your allopathic and osteopathic colleagues furnish.

APMA’s Position

APMA strongly opposes these proposed changes and is urging CMS to continue allowing podiatrists to bill using the same E/M codes that all other providers use, at the same rates of reimbursement. DPMs are recognized as physicians under the Medicare statute and the same billing standards should apply to the critical foot and ankle care podiatric physicians provide, and to value the exact same service differently is discriminatory and punitive.  

Read APMA’s Issue Brief for More Information

Take Action

APMA urges all members to log on to the APMA eAdvocacy website and write to CMS. If you have not previously used APMA’s new eAdvocacy site, you must register using either your Facebook account or by manually entering the information requested. A sample letter is provided for you, and APMA encourages members to customize the letter and include personal experiences or examples. Don’t delay—take action today. CMS will not accept comments after September 10!

After you take action, ask your patients, office staff, family, and friends to write to CMS using the template letter drafted from the patient perspective! 

APMA’s comprehensive campaign to ensure this discriminatory proposal is not finalized includes submitting its own comment letter, meeting with CMS directly, engaging congressional allies and external stakeholders, and facilitating submission of comment letters by component and affiliate societies.   

Comments or questions about the proposed rule can be directed to APMA’s Health Policy and Practice Department at healthpolicy.hpp@apma.org.


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