CMS releases final rule for 2017 Physician Fee Schedule

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The Centers for Medicare & Medicaid Services (CMS) released its final rule detailing the 2017 Physician Fee Schedule, with changes focused on bolstering primary care, behavioral health and diabetes prevention.

The revised regulations take effect January 1, 2017, and are geared toward providing physicians further incentive to practice quality care, according to CMS Acting Administrator Andrew Slavitt. “By better valuing primary care, behavioral health and prevention models like the Medicare Diabetes Prevention Program expanded model, we help beneficiaries access the services they need to stay well and live long, healthy lives,” he said in a statement.

Among the highlights:

  • Increased incentives for collaborative provision of behavioral health care. CMS is introducing new codes designed to encourage and reward care delivered by a team composed of primary care physicians and behavioral health specialists, based upon the psychiatric Collaborative Care Model.
  • New and revalued codes for complex, chronic care management. The rule focuses in part on new codes covering care activities that take place after the initial visit by a patient with multiple chronic conditions, which CMS describes as a “significant update” to the Physician Fee Schedule designed to improve support for primary care practitioners. The rule also introduces separate payments under a new code for assessing and planning care for patients with dementia or other cognitive impairments.
  • Expansion of the Medicare Diabetes Prevention Program. Beginning in 2018, CMS expects Medicare beneficiaries to be able to attend community-based programs designed to prevent the onset of diabetes through behavioral interventions. Patrick Conway, acting principal deputy administrator and chief medical officer at CMS, said the agency sees the program as a win-win, benefiting patients and reducing the overall cost of care. The agency also hopes to encourage employers and insurers to follow their lead and deploy similar programs for their care populations.

CMS also provided a detailed summary of changes to specific programs.