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February 7, 2019

The Centers for Medicare & Medicaid Services’ Overhaul of Office-Visit Payments—What’s the Bottom Line for Otolaryngology?

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston
  • 2Harvard Business School, Boston, Massachusetts
  • 3Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. Published online February 7, 2019. doi:10.1001/jamaoto.2018.4154

In November 2018, the Centers for Medicare & Medicaid Services (CMS) finalized historic changes to the Medicare Physician Fee Schedule in an effort to reduce administrative burden on health care professionals.1 This reform will overhaul Medicare payment for Evaluation and Management (E&M) office visits beginning in January 2021. These visits account for approximately 20% of all Medicare charges under the Physician Fee Schedule and are of particular importance to otolaryngologists,1 who provide a significant number of ambulatory services relative to other physicians.2 In 2016, otolaryngologists conducted more than 5.1 million E&M office visits with Medicare patients.3 Otolaryngologists should understand several key aspects of the CMS rule, which has important implications for patient care.4

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