Many physician leaders are worried about how the move will affect reimbursements, and this month, a coalition of 47 organizations wrote a letter to Congress urging them to halt the implementation of the code.
CMS said the add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care of complex patients. Physician leaders expect the code to “produce a significant increase in Medicare reimbursement for some physician specialties, with an opposite and negative impact on many others,” according to JDSupra.
The anticipated cuts are based on the policy’s budget neutrality in determining physician fee schedule payments.
In 2020, Congress attempted to implement the same code, but the 2021 Consolidated Appropriations Act delayed the add-on code until 2024. CMS estimates that the code, if passed, will be responsible for roughly 90% of the proposed budget neutrality reductions in the coming year, according to the report.
In its letter to Congress, the organizations contend the code is “poorly defined, lacks detail regarding appropriate use, and is not resource based,” according to the JDSupra report, and that it will “penalize clinicians who cannot, or do not, use it.”
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