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Medicare: Primary Care Reimbursement Increases

Nov 18, 2016

A recent Medicare update will have a positive effect on reimbursement for primary care and preventive care services in fiscal year 2017. The 2017 Physician Fee Schedule final rule has been completed and released, and  further illustrates the marketplace’s focus on a more cohesive, integrated, and cost-effective health care system.

The recently completed and released Physician Fee Schedule Final Rule for 2017 focuses on improving primary care payments for services provided by primary care physicians and other practitioners. 

These providers have demonstrated substantial efforts towards coordinated care and whose patients are specifically being treated via chronic care management for behavioral health issues, cognitive issues and multiple chronic conditions. Recent coding changes have been made which allot for payments of these services vs. previous bundled payments. These payment increases also  reward physicians for quality care through the Quality Payment Program.

The Final Rule for 2017 will also have positive effects for diabetes patients and diabetes care.  The Rule finalizes many policies of the Medicare Diabetes Prevention Program (MDPP). Beginning January 1, 2018, the MDPP will expand its model test to eligible Medicare beneficiaries, which is a historical event for CMS as this will be the first time a prevention model will be adopted under the CMS authority.

To learn more about the Physician Fee Schedule Final Rule for 2017, you can visit the Centers for Medicare & Medicaid Services and the Federal Register.

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Steven Bisciello

Steven Bisciello is a Health Care Services Group, Partner experienced in revenue enhancement programs, health care litigation, compliance and physician practice management.

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