CMS fee schedule doesn’t cover cost of complex care patients, study shows

Because the Medicare and Medicaid patients who incur the highest costs are those with multiple chronic diseases, documentation, coding and billing rules should encourage better care for these patients than they currently do, according to the study, “The Correlation of Family Physician Work With Submitted Codes and Fees” by Richard Young, MD, and Tiffany L. Overton, MPH, published in the American Journal of Managed Care.

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On average, the amount of time per visit observed in the study was 20 minutes, including the time required for documentation. The average fees collected for 10-, 20- and 40-minute visits were $84, $102 and $135, respectively, according to the study. These appointment times were consistent with patients with multiple chronic diseases, despite the fact that these patients have more issues to discuss with physicians than average patients.

Read the full report on Becker’s Hospital Review.

 

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