CMS Finalizes 2019 Medicare Rules

Medicare 2019 Final Rules on Physician Fee Schedule and Hospital Outpatient Payment System Released

In early November, CMS released the final regulations for the CY 2019 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS).  NAEC has prepared summaries of the rules and charts showing payment for epilepsy center services, which can be found here:

While Medicare payment rates for most epilepsy centers services are remaining fairly stable in both the MPFS and HOPPS for 2019, significant changes to the VNS and brain neurostimulator codes have occurred and a new ECoG code for the monthly review of data for patients on the RNS system can be reported, affecting reimbursement rates.  Due to significant physician stakeholder opposition (including a letter from NAEC, AES and ACNS), CMS did not finalize its proposal to consolidate and reduce reimbursement for level 2 – 5 evaluation and management (E/M) services.  Alternatively, CMS revised its proposals and delayed implementation of changes to E/M services (detailed in the MPFS Summary) to take effect in 2021.