3 Medical Billing and Coding Changes Expected in 2019

In July, the proposed Medicare physician fee schedule for 2019 was announced by CMS. CMS is working to make some changes to make things easier for providers while improving access for patients. Here’s a closer look at 3 billing and coding changes you can expect to see in 2019.

Part B Drug Payments Changes

CMS is proposing a way to pay for new drugs administered by physicians under Medicare Part B. Right now, during the first 2 quarters while a new medication is on the market, they pay the WAC or wholesale acquisition cost (WAC) and a 6% fee to cover the administration costs and overheads. With the 2019 proposed fee schedule, CMS proposes to replace this payment with the WAC and a 3% fee to closely match the actual cost of the medication.

Telemedicine Coding Changes

Medicare is going to begin paying for virtual check-ins where patients can connect with doctors via video chat or phone. This will give patients the ability to get care while avoiding unnecessary costs.

E&M Coding Changes

You can also expect to see some big changes in evaluation and management (E/M) billing and coding for 2019.