3 changes in Medicare’s 2020 final rule affecting GI practices

The American Society for Gastrointestinal Endoscopy outlined how the CMS final rule for 2020 will affect gastroenterologists.

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Three details:

1. Colorectal cancer surprise billing. CMS dropped its proposal requiring GI practices to alert patients of the possibility they may be billed if their screening colonoscopy becomes therapeutic if a polyp is removed.

2. Removal of screening colonoscopy adenoma detection rate from payment system. CMS finalized its rule to drop adenoma detection rate from its merit-based payment system. GI societies expressed disappointment in the decision, saying that encouraging GIs to improve their adenoma detection rate could reduce colorectal cancer incidence and deaths.

3. Collapsing payments for office and outpatient visits. CMS will reverse its rule to collapse evaluation and management levels two through four for established and new patients to outpatient centers and offices in 2021. GI societies and the American Medical Association worked together on a new CMS plan which retains five levels of coding for established patients and sets four levels of coding for new patients.

Read more here.

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