What’s Ahead for Physician Practices in 2020

Physician Practices: Here's what to expect in 2020

CMS (Medicare) issued its Final Rule - This final rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2020. Here's a sneak peek at a few of the changes that physician practices can expect in 2020:


  • There are 273 additions to ICD 10 CM, 21 deletions, and 30 revision including revisions to atrial fibrillation, diseases of lymphatic system, pressure ulcers and congenital diseases effective October 1, 2019.
  • There are also 394 changes to CPT, 248 new codes , 71 deleted and 75 revised including 6 new codes for on line digital visits, long term EEG, self measured blood pressure.

Recommendation: Study your new CPT and ICD coding books!

Medicare Physician Fee Schedule

CMS proposed increasing physician payment rates by 0.14 percent in 2020. After applying the budget neutrality adjustment required by law, CMS estimated the 2020 Physician Fee Schedule conversion factor is $36.09, up from $36.04 in 2019.

Scope of Practice

  • CMS is finalizing the “Physician Supervision for Physician Assistant (PA) Services” proposal, implementing CMS' reinterpretation of Medicare law that requires
    physician supervision for PAs’ professional services.
  • Federal Regulations require that PAs must furnish their professional services in accordance with Stats law and State scope of practice rules that are specific for the State in which the services are furnished to the extent that those rules describe the required relationship between physician and PAs including its collaborative nature and describe a form of relationship between physicians and PAs collaborative nature and describe a form of supervision for Medicare’ purposes.

Medical Record Documentation

Final rule contains a proposal to reduce burden by implementing a general policy that will allow all Physicians, Physician Assistants (PAs), Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Midwives(CNMs) and Certified Registered Nurse Anesthetists (CRNAs), each of whom are recognized as Advanced Practice Registered Nurses (APRNs):

  • To review and verify by signing and dating documentation in medical records without having to redocument notes the medical record includes. This principle apples to all Medicare covered services that each of whom are professional disciplines furnish and are paid under the MPFS.
  • In addition to physicians, residents , nurses and medical students, this provision includes PA and APRN students or other members of the medical teams, as individuals who are allowed to make notes in a patient’s medical record, can review and verify by physicians and APRNS, rather than redocumenting notes.

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