News & Analysis as of

Physicians MPFS Medicare

Robinson+Cole Health Law Diagnosis

CMS Proposes Several Changes Affecting Telehealth Services in the 2026 Medicare Physician Fee Schedule Proposed Rule

On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2026 physician fee schedule (PFS) proposed rule, which in pertinent part proposes several changes affecting the delivery and...more

Health Care Compliance Association (HCCA)

Compliance with Medicare’s updated 2024 split (or shared) visit policy

Split (or shared) visits—the current term used by the Center for Medicare & Medicaid Services (CMS)—allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to share patient visits on the...more

McDermott Will & Schulte

CMS Finalizes Changes to Clarify Physician and NPP “Split (or Shared)” Billing Policy

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On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule which, among other policy and regulatory changes, finalized...more

Davis Wright Tremaine LLP

Time, Gravity, and the Complexity of Stark: 2022 MPFS Stark Proposals

There are three things that cannot be stopped: time, gravity, and the increasing complexity of the Stark Law. To be fair, complexity has not been the goal of the Centers for Medicare & Medicaid Services (CMS). Rather, Stark's...more

McDermott Will & Schulte

CMS Proposes New Regulation to Clarify Physician and NPP “Split (or Shared)” Billing Policy

On July 13, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) proposed rule (Proposed Rule). The Proposed Rule sets forth CMS’ plans to revise...more

Health Care Compliance Association (HCCA)

CMS issues physician fee schedule update

Compliance Today (March 2021) - On January 7, the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network released the following physician fee schedule update...more

Health Care Compliance Association (HCCA)

Final Physician Rule Changes Supervision, Adds Telehealth Codes, Some Permanently

Report on Medicare Compliance 29, no. 43 (December 7, 2020) - In the 2021 final Medicare Physician Fee Schedule (MPFS) rule, CMS made both permanent and temporary changes to supervision, telehealth and other provisions,...more

Health Care Compliance Association (HCCA)

CMS Rules: Direct Supervision Is Gone, Prior Auth Is Here; Documentation Fix Has Limits

Report on Medicare Compliance 28, no. 40 (November 11, 2019) - CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in these procedures as part...more

Holland & Knight LLP

CMS Releases 2020 MPFS and QPP Proposed Rule

Holland & Knight LLP on

• The Centers for Medicare & Medicaid Services (CMS) published the Calendar Year (CY) 2020 Proposed Rule for the Medicare Physician Fee Schedule (MPFS). The MPFS dictates Medicare rates and policies under Part B, while the...more

Holland & Knight LLP

CMS Releases the 2019 MPFS and QPP Final Rules

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• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...more

Holland & Knight LLP

Top Takeaways for Medicare Physician and Hospital Payments in 2018

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2017, released the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System Final Rule for...more

Pierce Atwood LLP

CMS Continues Efforts to Improve Patient Care, Spending, and Population Health

Pierce Atwood LLP on

On November 2, 2016, the Centers for Medicare and Medicaid Services (CMS), released the 2017 Medicare Physician Fee Schedule (MPFS) final rule, which finalized a number of new policies designed to improve Medicare payment for...more

Baker Donelson

CMS Re-proposes Ban on Per-Click Fees for Space and Equipment Leases under Stark

Baker Donelson on

In the CY 2017 Medicare Physician Fee Schedule (CY 2017 MPFS), the Centers for Medicare & Medicaid Services (CMS) issued proposed updates to the physician self-referral law (Stark law). The primary Stark law update focused on...more

Womble Bond Dickinson

Use of Modifier 25 - 2017 Medicare Physician Fee Schedule Proposed Rule

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The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have reviewed the use of Modifier 25 to unbundle payments for evaluation and management (E/M) services when a procedure is...more

Stinson LLP

Reimbursement Change for Off-Campus Provider-Based Clinics, Physician Offices, and Ambulatory Surgical Centers

Stinson LLP on

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, a two-year budget deal with a key provision affecting hospitals and other health care providers. Effective January 1, 2017, the Act decreases the...more

King & Spalding

CMS Issues Medicare Physician Fee Schedule Final Rule

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On November 27, 2013, CMS released a 1,369 page display copy of the CY 2014 Medicare Physician Fee Schedule (PFS) final rule. The final rule, which was delayed because of the government shut-down in October, is scheduled to...more

Mintz - Health Care Viewpoints

CMS Issues Medicare Physician Fee Schedule Without Finalizing Proposal Most Harmful to Independent Laboratories

On the day before Thanksgiving and a little over one month after the end of the government shutdown, the Centers for Medicare & Medicaid Services (“CMS”) published a rule finalizing revisions to payment policies under the...more

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