Dr. Ness' E/M rule


Fam Pract Manag. 2008 Sep-Oct;15(8):18.

Dr. Nancy Ness' recommendation in “A Multiple-Service Rule for E/M Services” [Opinion, June 2008] is simply genius. The implementation is so simple. The reach is so broad. Her plan would go a long way to improve patient care, continuity, comprehensiveness and convenience while lowering cost and complexity. Is anyone at the Centers for Medicare & Medicaid Services listening?

Dr. Ness' suggestion for an E/M rule change makes sense. I am a bit surprised that those looking into containing Medicare costs have not stumbled upon this before. Certainly this was the type of calculus that was used in the days before Medicare and the multiplicity of health insurance plans. I hope this plan gets shared with the appropriate policy-makers.

I recognize it may create “turf” problems in some areas, but if implemented this would improve the remuneration of family physicians who are certainly capable of managing the type of problems presented in the article's example.


Copyright © 2008 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


May-Jun 2022

Access the latest issue
of FPM journal

Read the Issue

FPM E-Newsletter

Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights."

Sign Up Now



Measuring What Matters in Primary Care: Implementing the Person-Centered Primary Care Measure

Learn how family physicians are using the person-centered primary care measure and get tips for how to implement it in your practice.

Improving Adult Immunization Rates Within Racial and Ethnic Minority Communities

Part one of this two-part supplement series highlights QI processes to reduce vaccine disparities, identifies recommended adult vaccines, and discusses their importance among racial and ethnic minority communities.