On October 31, 2014, the Centers for Medicare & Medicald Services (CMS) announced the 2015 Medicare Physician Fee Schedule (MPFS) Final Rule.
Overall, the non-quality related payment changes result in a net 1.0% increase in payments to neurosurgeons for 2015 provided Congress acts to prevent a
21 percent cut in the sustainable growth rate (SGR) formula by next March 31, 2015.
Most significantly, CMS announced its intention to finalize a far-reaching plan to transition all global surgery services to 0-day global periods, beginning
with 10-day global services in 2017 and following with 90-day global service in 2018. CMS will provide additional details in its proposed 2016 Medicare
Physician Fee Schedule rule, which it will release in July 2015. This initiative is likely to result in substantial reductions in surgical fees.
Other provisions of interested include changes to the schedule for implementing values for new and revalued codes. Per the final rule, new values will be
Included in the proposed rule released annually in July, rather than waiting until the final rule, which is typically released on or before November 1. The
AANS and CNS supported this change, which will allow additional time for review and comment. For 2016, CMS will strive to include as many codes as
possible in the proposed rule, with full implementation of the new policy in 2017.
The rule also finalizes multiple significant changes to several federal quality reporting initiatives. Physicians who fall to satisfy the Physician Quality
Reporting System (PQRS) wil be subject to a -2.0% Medicare payment penalty in 2017. Despite pushback from organized neurosurgery, CMS removed
many measures that wil affect a neurosurgeon’s ability to satisfy reporting requirements in a meaningful manner, including the Perioperative Care
measures set, and the Back Pain measures set. CMS also upped the reporting requirements for 2015 to nine measures, Including one “cross-cutting”
measure, for 50% of applicable Medicare Part B patients. Unfortunately, the “cross-cutting” measure set is primary care focused and of little relevance to
neurosurgery. Individuals reporting via a Qualified Clinical Data Registry (QCDR) in 2015 will be required to report on nine measures, Including two
outcomes measures, for 50% of all applicable patients seen over the reporting period (both Medicare and non-Medicare). Organized neurosurgery,
through the NeuroPoint Alliance, continues to evaluate the possibility of becoming a QCDR, which would offer neurosurgeons the opportunity to report on
more meaningful quality measures.
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