5 key GI payment updates from proposed CMS 2017 fee schedule

CMS proposed the 2017 Medicare Physician Fee Schedule earlier this year with a few changes for gastroenterology and GI procedures.

Here are five notes on the changes from an AGA, ASGE and ACG report:

1. The fee schedule proposes a new value for moderate sedation codes. The associated value is removed from most endoscopic procedures, so physicians performing their own moderate sedation won’t see an impact but anesthesia professionals performing moderate sedation would see reduced work RVUs.

2. Despite the moderate sedation changes, the proposed rule maintains the value of anesthesia services for upper and lower endoscopy over the next year. CMS reportedly wants to re-examine the value of these services.

3. CMS proposes modification to select APCs, moving biopsy codes for esophagoscopy, colonoscopy through stoma and colonoscopy to payment Level 2. Flexible sigmoidoscopy, EGD and ERCP would remain in payment Level 1.

4. There were several updates for quality reporting as well; ASCs could see 2 percent decrease in payment for Medicare if they don’t participate in the ASCQR program. There are seven new measures proposed for the program.

5. The proposed rule extends electronic health reporting periods to 90 days for all returning participants in the EHR Incentive Program instead of a full year of reporting.

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