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Docs, Specialists ID Proposed Payment Fee Concerns

Cheryl Clark, for HealthLeaders Media, July 15, 2014

"They may have been in the hospital recently, might have home health coming to see them, or have seen a specialist, and I have to go through all those reports, keep up with medications, and a lot of that doesn't happen in the office, yet it's stuff we, and I, do routinely because our patients need it."

G-Code Poses 'Administrative Burden'
Shari Erickson, vice president for governmental and regulatory affairs for the American College of Physicians, adds that "CMS appears to be loosening some of the requirements for doctors to be able to receive" this G-code. And that's a good thing."

An ACP review, however, suggests the amount should be more in the range of $70. "Whether $41.92 is enough to make this work—that's what we're having to take a look at.," Erickson says. "There's a big difference between $70 and $41.92."

Another concern is that the G-code will be difficult to bill for, Erickson says.

The proposed rule requires physicians to have electronic health record systems that are certified under 2014 meaningful use standards, and to have care plan and structured data capabilities that capture claims information, but the 2014 MU standards don't require that.

CMS is essentially asking doctors to adhere to a standard that does not yet exist, Erickson says. "We’re going to need to get a clarification, obviously."

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