CMS's 2019 Physician Fee Schedule final rule details how anesthesia practices will be paid in 2019 and how their participation in the Quality Payment Program could affect what they're paid in 2021, according to Anesthesia Business Consultants President and CEO Tony Mira.
Here are six insights:
1. The nation's average anesthesia conversion factor increased from $22.19 to $22.27 in 2018.
2. The non-anesthesia conversion factor increased from $35.99 to $36.04. Anesthesiologists would use this conversion factor to bill for flat-fee services.
3. CMS reduced the work relative value unit for CPT code 95970 from 0.45 to 0.35 for 2019. CPT code 95970 represents electronic analysis of implanted neurostimulator pulse generator/transmitter.
4. In 2019, CMS will also implement changes in documentation requirements for evaluation and management services. The changes are intended to reduce administrative burden.
5. Providers will see several changes to the QPP in 2019, including expanded low-volume threshold criteria, expanded opportunities to opt-in to the Merit-based Incentive Payment System and the removal of 21 MIPS clinical quality measures.
6. Eligible participants will now be required to achieve at least 30 MIPS points to avoid a negative payment adjustment of up to 7 percent in 2021, and certain facility-based clinicians will be allowed to use the hospital value-based purchasing program measure for their quality and cost scores.
Click here for a final rule fact sheet and here for a Quality Payment Program fact sheet.