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:

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