As the agency spelled out in 44 pages of its final, 1,369-page Physician Fee Schedule rule last week, doctors will be able to bill separately for these types of non-face-to-face services starting Jan. 1, 2015. This is in addition to payment for evaluation and management (E/M) codes covering the face-to-face encounter. Although the G-code is valued at only 20 minutes of non-face-to-face activity per Medicare beneficiary every month, or roughly $30 depending on geographic or other pay adjustments, at least it's something.
"Overall we're very pleased," says Shari Erickson, vice president of governmental and regulatory affairs for the American College of Physicians, which represents 137,000 internists. Primary care practices are best poised to take advantage of this new revenue stream. "We've been asking CMS to pay for these services for quite some time, and CMS made a lot of changes from their original proposal that are more in line with what we're looking for."
Adds Reid Blackwelder, MD, president of the American Academy of Family Physicians, which represents 110,600 practitioners, "The G-code" is a good thing for patients and doctors, and definitely a step in the right direction."
In its November 27 rule, CMS officials specified that the agency now believes "successful efforts to improve chronic care management for these patients could improve the quality of care while simultaneously decreasing costs."