CMS’s aim to cut documentation will be a payment cut

When CMS proposed several changes to the Physician Fee Schedule and Quality Payment Program in July, it was under the guise that the agency was knocking off burdensome documentation requirements for physicians. Presumably, the less time doctors spent on paperwork, the more they could be with patients.

However, the agency’s own proposal states documentation time won’t actually be reduced by much—but the changes will likely come with a payment rate cut.

“CMS says it will save something like 500 years in documentation,” Drew Voytal, MPA, associate director of government affairs for the Medical Group Management Association, said during a recent presentation in Boston at the association’s annual convention.

However, digging a little further into the proposal, “CMS themselves say, really, we don’t think this will cut documentation,” Voytal said.

One key part of the proposal that will result in a payment cut is CMS’s idea to overhaul evaluation/management (E/M) coding and payment policies by creating one payment rate for four different levels of office and outpatient E/M visits. Doing so effectively reduces the payment rate for codes 4 and 5. Under the notion of cutting documentation, the proposal would actually reduce payments with few documentation adjustments.

“It’s important to know they think they buried the book about it,” Voytal said.

The association also called the proposals “misguided.”

The changes in the proposed rule are far-reaching, but the E/M coding changes have “gotten the most attention” from providers as a result of the possible rate cut, according to MGMA.