2014

HomeWashington Letter2014 ▶ CMS Releases 2015 proposed Medicare Physician Fees Schedule/Hospital Outpatient Prospective Payment Rules
CMS Releases 2015 proposed Medicare Physician Fees Schedule/Hospital Outpatient Prospective Payment Rules

July 2014

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released two major proposed rules for 2015, the Medicare Physician Fee Schedule, which covers Medicare payment to physicians and other Medicare Part B providers, and the Hospital Outpatient Prospective Payment System rule, which covers Medicare policies and payment for hospital outpatient procedures.

For the Hospital Outpatient Prospective System rule, in general, bronchoscopic services saw a 10 percent increase in payments, ventilator management codes saw a 4 percent decrease, most pulmonary function tests saw payment increases, sleep studies and sleep interventions saw small cuts, and pulmonary rehabilitation codes had mixed results, with G0424 (pulmonary rehab with exercise) seeing a 26 percent increase and G0239 (other respiratory group) seeing a -27 percent change. For more information on selected services in the Medicare Hospital Outpatient Prospective Payment System, please click here ATS HOPPS 2014 vs 2015.

In the Medicare physician fee schedule, codes of interest to the ATS community saw minor changes. CMS estimates the overall impact of the proposed 2015 fee schedule to have a positive 0 percent impact on pulmonary care payments and a positive 1 percent impact on total critical care payments. CMS does not provide a separate estimate for sleep payments. For more information on select pulmonary, critical care and sleep procedures, please click here ATS MPFS 2014 vs 2015.

In addition to payment changes, CMS has proposed a number of changes to Medicare quality reporting programs, including retiring COPD and sleep apnea quality group measures.

The ATS will provide more details of the Medicare Physician Fee Schedule and the Hospital Outpatient Prospective Payment System proposed rules as we continue our analysis of these major policy proposals.

Last Reviewed: October 2017