Internists Applaud CMS for Raising Payments for Office Visits, Reducing Documentation in Final Payment Rule

Washington, D.C. November 4, 2019 – The American College of Physicians (ACP) commends the Centers for Medicare and Medicaid Services (CMS) for improving payment for evaluation and management (E/M) codes and reducing documentation burdens in the final rule for the 2020 Medicare Physician Fee Schedule.

“Medicare has long undervalued E/M codes (office visits) by internal medicine physicians, family physicians, and other cognitive and primary care physicians. At the same time, physicians were faced with excessive documentation requirements to be paid for such services,” said Robert McLean, MD, MACP, president, ACP. “ACP is extremely pleased that CMS’s final payment rules will strengthen primary and cognitive care by improving E/M codes and payment levels and reducing administrative burdens, in line with ACP’s Patients Before Paperwork initiative.”

In September, ACP submitted a letter to CMS Administrator Seema Verma applauding the agency for adopting recommendations from the Specialty Society Relative Value Scale Update Committee (RUC) to increase payments for office and outpatient E/M visits. ACP was a leader in pushing for improved reimbursement and documentation changes for E/M services.

“ACP applauds CMS for its decision to implement the recommended E/M payment (relative values) and coding changes and reduce the time that physicians must spend documenting them, freeing up time for physicians to spend with their patients to provide high quality care,” said Dr. McLean. “Allowing either the use of time or medical decision making to determine the level of visit is a significant improvement.” 

These changes also will help address the growing shortage of primary care physicians.

“Fewer physicians are going into office-based internal medicine and other primary care disciplines in large part because Medicare and other payers have long undervalued their services and imposed unreasonable documentation requirements,” said Dr. McLean. “CMS’s new rule can help reverse this trend at a time when an aging population will need more primary care physicians—especially internal medicine specialists to care for them.”

ACP is still evaluating both the physician fee schedule and Quality Payment Program rules and will provide input about other provisions that they support and identify opportunities for improvements.

“We strongly urge that the E/M payment and documentation proposals in the final rule be implemented as proposed to strengthen access to care and to enable physicians to spend the necessary time with patients. Furthermore, we urge Congress to express its strong support to CMS for improving payment, coding and documentation for E/M services,” said Dr. McLean. “ACP believes this regulatory improvement can help bring the focus back to the physician-patient relationship instead of the physician-computer relationship.”


About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 159,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter, Facebook, and Instagram.