CMS Releases Medicare Rules

Nov 30, 2019 Re-posted from the December 2019 issue of Vascular Specialist

The Centers for Medicare & Medicaid Services has issued its CY2020 final rules on Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs (HOPPS).

These rules will go into effect on Jan. 1, 2020. Highlights for vascular surgery include:

  • The Medicare conversion factor will increase by 0.14 percent.
  • IBE implantation now has Category 1 codes.
  • There are new pre-op AVF artery/vein mapping codes.
  • Procedures performed in outpatient-based facilities will see a continued decrease in compensation or overhead.
  • Stab phlebectomy codes were revalued and now are 10-day global codes.
  • E/M coding is being overhauled for 2021.

Details on global code issues in the PFS are available in the SVS “DC Update” November electronic newsletter (vsweb.org/DCUpdateNov2019). SVS and its colleagues in the surgical community strongly opposed CMS efforts to limit the updated adjustments to Evaluation and Management code values and not apply the new adjusted values to global codes.

Despite the opposition, CMS has announced it would adopt the policy as part of the PFS.

“The SVS Coding Committee has worked and will continue to work of behalf of the SVS membership to advocate for fair and appropriate reimbursement,” said Matthew Sideman, committee chair. “We will continue to oppose, vigorously, policies that negatively impact reimbursement for surgical procedures and we will update SVS members about this important issue.”

To review the Final Rules in their entirety visit:

Tags
Vascular Specialist

Related Articles

Education and Representation at the Core of Inclusivity Efforts for DEI Committe

This article was published in the October issue of Vascular Specialist.

The Society for Vascular Surgery’s (SVS) Diversity, Equity, and Inclusion (DEI) Committee continues to make strides in advancing inclusivity within the organization, with several projects underway to address both ongoing challenges and new opportunities.

Why donate to the SVS PAC?

A few years ago, in his presidential address to the Midwestern Vascular Surgical Society, Mark Mattos, MD, spoke eloquently about the need to “protect our specialty.” A large part of this, he argued, is protecting our patients; no other specialty in medicine can provide the type of comprehensive vascular care that we offer. The daily reality we all face is the potential for declining Medicare reimbursement for our services.

Progress made during year like no other

While the COVID-19 pandemic and its effects dominated 2020–21 fiscal year—including the cancellation of the live 2020 Vascular Annual Meeting (VAM)—it did not deter progress on many important initiatives. “When covid hit, it intensified our focus on what was truly important: our members, their patients and the SVS as their Society,” said Executive Director Kenneth M. Slaw, PhD. “That focus was sustained the past 15 months and it has led to innovation and an unprecedented volume of member value programs.” He outlined important highlights from the fiscal year that ended March 31—just more than a year after the pandemic was declared—and the vital initiatives that continue to move forward.