BEDFORD, MA--(Marketwired - Jan 25, 2016) - LogixHealth has published its newest physician-focused Intelligence Briefing: 2016 Emergency Department Physician Update. The Medicare 2016 Physician Fee Schedule final rule governs payment and other critical reimbursement issues, for dates of service beginning on January 1, 2016. The rule, published in the November 16, 2015 Federal Register, and the full 2016 Emergency Department Physician Update can be found on the LogixHealth website.
"Failing to meet the PQRS reporting requirements in 2016 will automatically result in a 4.0% decrease in 2018 payments under the Value Modifier program," says Elijah Berg, M.D., CEO of LogixHealth.
MACRA Legislation Eliminates the Sustainable Growth Rate Formula
With passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), on April 16, 2015, the previously scheduled annual SGR cuts have been permanently repealed.
2016 Conversion Factor
The Medicare conversion factor (amount Medicare pays per RVU) was set at $35.9335. MACRA provides for annual conversion factor increases of 0,5% through 2019. However, two additional pieces of legislation mandate cost savings
of 1%, resulting in a final 2016 conversion factor of $35.8279.
2016 RVUs for ED E/M Services
Each year, updated RVUs for physician services are published in the final rule. For 2016, RVUs for emergency medicine services remain unchanged. Total RVUs associated with the ED E/M services 99281-99285 and 99291 will experience minimal changes.
New Merit Based Incentive Payment System (MIPS)
The three existing quality programs (PQRS, Value Modifier, and EHR) will be consolidated under the Merit-Based Incentive Payment System (MIPS) starting in 2019, which will adjust payments based upon four performance categories:
- Quality
- Resource use
- Clinical practice improvement activities
- Meaningful use of an electronic health record system*
*On January 12, 2016 acting CMS Administrator Andy Slavitt stated "Meaningful Use will likely end in 2016
and be replaced by something better.
Physician Quality Reporting System
The Physician Quality Reporting System (PQRS) continues for 2016. Groups not reporting PQRS measures in 2016
will receive a 2.0% penalty assessed against their 2018 Medicare allowables.
About LogixHealth:
With two decades of experience providing coding, billing and end-to-end revenue cycle services for top hospitals, office based practices and emergency departments in over 30 states nationwide, LogixHealth offers healthcare providers the tools and resources needed to optimize their practices and improve the overall delivery of care. For more information, visit www.logixhealth.com.