Proposed 2018 physician fee schedule includes reduced burden on physicians

The Centers for Medicare and Medicaid Services (CMS) today released the proposed 2018 Medicare Fee Schedule. As part of a statutory across-the-board reduction in payments, the rule proposes an overall 1% decrease to dermatology payments.

Within the proposed rule, CMS solicits ideas for making the health care delivery system less bureaucratic and complex for physicians, providers and patients. The American Academy of Dermatology Association (AADA) has already engaged with the Administration in this area, strongly advocating for relief for physicians, and appreciates that CMS has been responsive to our requests.

For example, the rule proposes that the current Physician Quality Reporting System (PQRS) program only require reporting of 6 measures down from the current program policy of 9 measures. CMS also proposes reducing the penalties for not meeting minimum quality reporting requirements under the value-based modifier, and not penalizing physician groups and solo practitioners who meet quality reporting requirements under quality-tiering for the last year of the program.

The 2018 proposed fee schedule includes a number of other important items for dermatology. CMS proposes:

  • New values for new and existing photodynamic therapy codes to allow for the identification of physician time versus staff time. The AADA will be working to ensure that the new values are appropriate.
  • Added codes for telehealth services and the proposed elimination of the required reporting of the telehealth modifier to reduce the administrative burden on physicians.
  • Changing the guidelines for evaluation and management codes and the use of patient relationship codes.
  • Cutting payment for certain off-campus provider-based hospital department services by 50% (the AADA will be carefully evaluating the impact).

The proposed rule does not include information regarding the new biopsy code values that were reviewed in 2017. Those are expected to be published in 2018.

AADA staff continues to analyze the rule, will be publishing other analyses, and plans to submit comments to CMS by September 11, 2017. Additional information on the 2018 proposed rule will be made available in Dermatology World Weekly and on

For a fact sheet on the proposed rule, please visit:

Source: American Academy of Dermatology Association

Ask Dr Dave Article 78

Ask Dr. Dave: How will ICD-10 Impact My Practice?

In my travels throughout the country, I get asked a lot of questions. The hottest topic, by far, is ICD-10 and what it will mean to the average independent practice. To be candid, as Chief Medical Information Officer for MedcoData, it is my responsibility to speak with medical professionals regarding the various solutions we’ve designed to help practices transition to ICD-10. As such, I have a vested interest in making sure that you are properly forewarned of the implications associated with what could prove to be a very disruptive event for the average independent practice.

Regardless of my interests, though, you, as a medical professional, need to be acutely aware of how different your day at the office could be on October 1st if you haven’t taken the necessary steps to prepare. More importantly, you’ll need to be fully prepared for just how different the patient experience projects to be.

Here are just a few of the more significant implications of the roll-out;

  • Physicians/clinical staff will need comprehensive training on coding
  • Fundamental changes to templates, superbills, etc. will be necessary
  • Interfaces may need to be re-written to accommodate codes
  • Custom reports will likely need to be re-written
  • Patient’s problem list & family-history must be updated to ICD-10 codes
  • Cash flow may very well be a serious concern if you’re not prepared

As a physician, I understand the vital need for comprehensive and efficient processes when it comes to the management of a medical practice. As a business executive, I understand that no enterprise, much less a medical practice, can survive externally imposed changes to process without a plan. Likewise, no enterprise can survive a sustained downturn in receivables caused by the negative impacts of change, and this is likely the most significant issue of all. As you and your team adjust to the new ICD-10 reality, it is highly probable that fewer patients will be seen. Fewer patients equates to less revenue, of course, and so the need for preparation becomes clear.

For a great resource on all things ICD-10, please go to the Centers for Medicare & Medicaid Services website, Once there, you’ll have access to a number of great resources and articles on how to prepare for October 1st and beyond. There is a lot of information to dig into, of course, and very effective recommendations as well. If you’re curious or concerned about where to begin, or if you’re coming to the conclusion that perhaps you’ll need some expert assistance to get the job done, the following list of links will take you to the many solutions MedcoData offers to help the independent practice manage what may prove to be a truly challenging time.

As you’ll see when you go to the website, the clock is ticking. If you think MedcoData may be able to help, give us a call today and breathe easier, knowing that our team of trusted advisors will be there for you every step of the way.

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