decisionhealth Newsletters, Coder Pink Sheets - 2017 Issue 12 (December)
Final 2018 physician fee schedule: Medicare 2018 fees remain flat, therapy cap exemptions to end this year
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Article Overview
This premium article reviews the 2018 Medicare physician fee schedule and highlights how CMS finalized payment and valuation changes across multiple service areas. It is aimed at physicians, coders, and practice managers who need to understand broad Medicare reimbursement updates, therapy policy timing, imaging payment adjustments, and selected code revaluation activity. The article also covers delayed implementation of appropriate use criteria reporting and other policy changes that may affect practice operations in 2018 and beyond.
Why This Topic Matters
These annual Medicare updates can affect reimbursement, workflow, and compliance across physician practices, especially in orthopedics, imaging, pain management, therapy services, and addiction treatment. Understanding the scope of the final rule helps practices anticipate payment changes and policy deadlines.
Article Sections
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Overview of the final 2018 physician fee schedule
Summarizes the overall Medicare payment outlook for the year and the types of reimbursement changes discussed in the article.
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Therapy caps and exception process timing
Discusses annual therapy cap updates and the scheduled end of the exception process, along with related legislative context.
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RUC revaluation and selected code updates
Covers services and code groups sent for review or assigned updated relative value work, including several physician and procedure services.
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Computed radiography modifier and technical component change
Reviews the imaging-related payment adjustment tied to non-digital computed radiography and the reporting change associated with it.
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New buprenorphine implant codes
Describes the addition of new reporting options for opioid addiction treatment implant services and the general payment context.
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Pain management procedure RVU changes
Summarizes updated valuation for selected pain management and neurostimulator-related procedures.
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Nerve repair procedures and add-on reporting
Explains CMS action on nerve repair services and related code status changes.
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Orthotics and prosthetics RVU revisions
Reviews changes affecting management and training services for orthotic and prosthetic encounters.
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Appropriate use criteria implementation delay
Covers the revised timeline for imaging-related appropriate use criteria and the limited early reporting option.
What You Will Learn
- How the 2018 Medicare physician fee schedule affects broad reimbursement trends
- Which service areas saw valuation, policy, or reporting changes
- How therapy cap timing and imaging-related policy updates may affect practice operations
- Which specialty-focused payment updates are discussed for orthopedics, imaging, pain management, and addiction treatment
- How CMS adjusted the implementation timeline for appropriate use criteria reporting
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Orthopedic practices
- Radiology and imaging practices
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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