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CHA Issues Summaries of CY 2020 Physician Fee Schedule and Quality Payment Program Final Rule

For CFOs, CMOs, finance & reimbursement staff, quality staff

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CHA has issued the two summaries, prepared by Health Policy Alternatives, detailing provisions of the calendar year 2020 physician fee schedule and quality payment program final rule. The policies described in the summaries are generally effective Jan. 1.

Part I of the summary details payment policies and updates under the physician fee schedule, including changes to CMS’ evaluation and management services payment rates; coding and payment for a bundled episode of care for management and counseling for opioid use disorder; updates to payment for case management and therapy services; and changes to the Medicare Shared Savings Program.

Part II details policies related to the physician quality payment program, including the 2020 policies related to the Merit-Based Incentive Payment System (MIPS), as well as the creation of the MIPS Value Pathways beginning in 2021. The summary also outlines minor technical changes finalized for incentives for participation in alternative payment models.

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