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CMS responds to physician concerns, delays payment changes until 2021

By AOA Media Team


CHICAGO—November 2, 2018—Yesterday, the Centers for Medicare & Medicaid Services (CMS) released for public inspection the Medicare Physician Fee Schedule Final Rule for calendar year (CY) 2019, announcing modifications to its proposals for office and outpatient Evaluation and Management (E/M) visits for new and established patients.

The American Osteopathic Association (AOA) applauds CMS for adopting several recommendations made by the AOA and other stakeholder groups that will provide immediate relief of burdensome and duplicative documentation requirements, and for delaying implementation of final payment policy changes. “The two-year delay will allow the AOA time to continue working with CMS to refine E/M policy changes in the best interest of patient care prior to implementation,” said AOA President William S. Mayo, DO.

CMS did not finalize proposals to allow same day billing by the same practitioners of the same group or specialty, create new codes for podiatry visits, or create a single PE/HR value for E/M visits. CMS also did not finalize its proposal to adopt a multiple procedure payment adjustment. This means that OMT codes will not be subjected to a 50 percent cut when billed with an E/M visit appended with Modifier 25.

In addition to direct engagement with CMS and collaboration with other stakeholder groups, the AOA facilitated the submission of comments by more than 1,000 practicing DOs. “The AOA is grateful that CMS headed the concerns expressed by practicing physicians about the proposed rule and looks forward to advancing the dialogue on how physician payment policy can be modified for the betterment of both physician practice and the patients we care for,” Dr. Mayo said.

About the AOA
The American Osteopathic Association (AOA) represents more than 137,000 osteopathic physicians (DOs) and osteopathic medical students; promotes public health; encourages scientific research; serves as the primary certifying body for DOs; and is the accrediting agency for osteopathic medical schools.

To learn more about DOs and the osteopathic philosophy of medicine, visit