December 1, 2017

CMS Issues 2018 Final Quality Payment Program Rule

On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released a final rule to continue implementation of the Quality Payment Program (QPP) required by the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). MACRA was bipartisan legislation signed into law in the spring of 2015 to permanently repeal the Sustainable Growth Rate (SGR), streamline quality reporting programs, and provide incentive payments for participation in advanced alternative payment models. After an initial rulemaking last year, the QPP went into effect January 1, 2017. Based on feedback from stakeholders over the last several months, CMS has finalized some changes to the QPP and its two tracks for Medicare payment in 2018 and beyond: Merit-Based Incentive Payment System (MIPS) […]
December 1, 2017

CMS Issues 2018 Final Hospital Outpatient and ASC Rule

On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released the 2018 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System policy changes, quality provisions, and payment rates final rule. Please note that physician payment is made under the Physician Fee Schedule; hospitals are paid for outpatient services under the OPPS and ASCs are paid under the ASC payment system, both detailed in this rulemaking. CMS is increasing the OPPS payment rates by 1.35 percent for 2018. After considering all other policy changes under the final rule, including estimated spending for pass-through payments, CMS estimates an overall impact of 1.4 percent payment increase for hospitals paid under the OPPS in 2018. CMS updates […]
December 1, 2017

CMS Issues 2018 Final Physician Fee Schedule

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018. The PFS pays for services furnished by physicians and other practitioners in all sites of service. These services include but are not limited to visits, surgical procedures, diagnostic tests, therapy services, and specified preventive services. As part of the final rule, CMS issues final values for new codes and codes deemed misvalued. Please see the spine code spreadsheet for a comprehensive comparison of RVUs and reimbursements of spine procedures from the 2017 final rule to the 2018 final rule. Some […]
November 30, 2017

ISASS Policy & Advocacy News – November 2017

News and noteworthy information for November 2017: ISASS Advocacy NCCI Edits – Cage & Instrumentation Coding CMS Issues 2018 Final Physician Fee Schedule CMS Issues 2018 Final Hospital Outpatient and ASC Rule CMS Issues 2018 Final Quality Payment Program Rule Quality Payment Program – Act NOW to Avoid Losing 4% of your Medicare Reimbursements   ISASS Advocacy Chair of the ISASS Coding & Reimbursement Task Force and winner of the 2017 ISASS Distinguished Service Award, Morgan Lorio, MD highlights the Society’s advocacy work over the past year. “ISASS’ advocacy action takes many forms across multiple forums, but at the most basic level, our number one goal is to support spine surgeons and spine patients,” Lorio said. “We do this through […]
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