The Federal Register published Medicare's 2017 final fee schedule rule on Nov. 15. It updates payment policies and rates for services furnished under the Medicare Physician Fee Schedule on or after Jan. 1, 2017. Although the original proposed rule included an expected fee schedule cut, the final rule increases the fees by a very small amount, less than one-quarter of 1 percent.
Other provisions include:
- Very small changes to the geographic adjusters and to many relative value units (RVUs), so the combined effect will be small changes to most payments;
- Part B annual deductible for 2017 is $183;
- A new required place of service code for telehealth services and a few new codes that can be billed via telehealth;
- A new required modifier and reduced payment for radiology procedures using film to encourage the move to digital;
- Payment now allowed for non-face-to-face prolonged evaluation and management (E/M) services;
- New payable G codes for behavioral health integration services;
- Reworked coding and payment for all mammography services, temporarily using G codes until new CPT codes can be finalized;
- Simplified requirements for chronic care management services; and
- A reminder that qualified Medicare beneficiaries, who are also covered by Medicaid, may not be directly billed for co-insurance and deductibles.
In addition, the final rule addresses other topics related to the Medicare program, such as release of certain Medicare Advantage bid data and Part C and Part D Medical Loss Ratio data, enrollment requirements for providers and suppliers in Medicare Advantage, and the Medicare Diabetes Prevention Program expanded model. For more details on the Diabetes Prevention Program model test, visit the fact sheet for that portion of the rule.
The complete fee schedule is available for download from the Novitas website.
Action, Dec. 15, 2016
Last Updated On
December 15, 2016