CMS Issues Proposed 2018 Medicare Physician Fee Schedule

AAFP Begins Work on Review, Response

July 17, 2017 12:10 pm News Staff

On July 13, CMS issued a proposed rule that would update the Medicare physician fee schedule for 2018. The proposal is now available for public review( and is scheduled to be published in the Federal Register on July 20.

[Words Hot Topic in flames]

According to a CMS press release,( the proposed rule would bring the nation one step closer to modernizing the health care payment system.

Importantly, CMS invited public comment on ways to further reduce the plethora of administrative tasks that clearly frustrate physicians.

"Doctors want to spend less time on burdensome regulation from Washington, D.C., and more time with their patients," said CMS Administrator Seema Verma, M.P.H., in the release.

A fact sheet( on the proposed ruled is available from CMS.

The AAFP was quick to respond to the announcement with a July 14 statement from AAFP President John Meigs, M.D., of Centreville, Ala., that commended CMS for listening to family physicians' concerns and including some Academy recommendations for decreasing the administrative load Medicare has placed on the shoulders of participating physicians.

He specifically applauded CMS' recognition that current evaluation and management (E/M) documentation guidelines, which were constructed more than 20 years ago, are no longer relevant. The E/M guidelines "do not reflect the current use of electronic health records and team-based care" that physicians use to support clinical decision-making and patient-centered care, said Meigs.

"The AAFP has called for changes in these outdated documentation guidelines, and we look forward to providing our recommendations to CMS," he added.

Meigs pointed to several other improvements in the proposed rule that the AAFP has repeatedly urged CMS to consider. For instance, the agency proposed

  • implementing site-neutral provisions to new off-campus, provider-based departments;
  • delaying the launch of the Medicare appropriate use criteria program for diagnostic imaging services until 2019; and
  • lowering the maximum level of risk that physicians in practices with fewer than 10 physicians would face under the 2018 value modifier program from 4 percent to 1 percent.

However, Meigs expressed disappointment regarding CMS' inaction on another front.

CMS has "failed yet again to achieve the required minimum net expenditure reduction through identifying misvalued codes," he said.

"Since these changes do not fully meet the misvalued code target required by law, physicians will not receive the full positive 0.5 percent update in 2018 called for in the Medicare Access and CHIP Reauthorization Act," Meigs stated.

Lastly, Meigs acknowledged that changing the physician payment system would take time.

"As CMS moves to replace payment for individual procedures with payment for value and quality of care, we remind the agency that it's important to strengthen the primary medical care that supports the system-wide reforms taking place today and for years to come."

As always, the AAFP will thoroughly review the proposed rule before responding to CMS' request for comments by the Sept. 11 deadline.

Related AAFP News Coverage
2017 Medicare Physician Fee Schedule
AAFP Reminds CMS of Issues Not Addressed in Final Rule