2017 Medicare fee schedule

Proposed 2017 Medicare fee schedule released

A proposed rule for Medicare's 2017 Physician Fee Schedule contains several policies that will impact doctors of optometry participating in postoperative care, diabetes care and Medicare Advantage plans.

"CMS estimates that doctors of optometry will receive about $1.21 billion in Medicare reimbursement in 2017."

The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule on July 7 to update policies affecting payment rates and quality provisions for Medicare services furnished during the 2017 calendar year. A number of these proposed policies take aim at improving Medicare payment for services rendered by primary care physicians for patients with multiple chronic conditions, CMS notes.

AOA intends to file formal comments on the proposed rule ahead of the Sept. 6 deadline, bolstering support for optometry-friendly policies and highlighting several concerns. Among these proposed policies affecting doctors of optometry:

  • CMS intends to place a greater emphasis on diabetes care and prevention, and AOA will work with CMS to determine how doctors of optometry can best serve this important Medicare population.
  • CMS is mulling over how best to gather data on the quantity of office visits during the surgical postoperative period. Over the past several years, CMS has grappled with how to appropriately value codes with a global period.
  • CMS is working on how to improve and refine the Open Payments program and AOA will provide feedback to make this program less burdensome for doctors.
  • AOA is watching closely CMS proposals related to telehealth services to ensure that patient care is not compromised. CMS has indicated that a place of service code may be developed for telehealth services. 
  • CMS is asserting authority related to what they consider to be "overpayments" (paid claims later found to be potentially incorrect) to physicians.  CMS has proposed that when a doctor is liable for overpayments, CMS may recoup funds from other doctors under the same Tax Identification Number, if necessary.

Finally, CMS is proposing new enrollment criteria for doctors providing care through Medicare Advantage plans, but who are not enrolled in Medicare Part B. The AOA will keep doctors informed about this plan.

As for calendar year 2017, CMS estimates that doctors of optometry will receive about $1.21 billion in Medicare reimbursement, up from the $1.17 billion received in 2016 and $1.16 billion in 2015.

July 19, 2016

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