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New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care

Cheryl Clark, for HealthLeaders Media, December 5, 2013

So how might CMS' change of heart improve quality of care? Erickson says much of the changes will involve reassignment of duties among staff who now perform coordination functions "on an ad hoc" basis, as time allows.

One example is that the RN may call the patient before the visit to clarify the patient's reason for coming in, she says. "If you identify what the patient wants to do before they get there, it cuts back on those last minute, 'oh, doctor, by the way' questions as the physician is walking out the door, but which were the reason the patient came in the first place," she says.

Other types of improved quality might include following up with referral specialists to make sure the patient was seen and what type of care ensued. Practices might block out time at the end of each day to accomplish some of these tasks that otherwise slip through the cracks.

"This is an on-ramp," Erickson says. "It gets some money in the door to provide consistent, systematic care coordination for patients with multiple chronic conditions." In time, she says, ACP will work to have such services rewarded even more, in line with the trend to pay for value rather than volume.

It's a work in progress, she says, "like trying to fix a plane while you're flying in it." Though few doctors are aware of the new provision, in coming months ACP will launch an educational campaign to get the word out. For now, doctors will have a year to prepare for it.

"We hope the G-code will have a significant impact," she says.


See Also: CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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3 comments on "New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care"


Bonnie (1/15/2014 at 11:41 AM)
They should do the same thing for Medicaid, but that's not federal. A lot of times when everyone else makes sense, state laws do not. People will have to start bugging their state officials to come up with something for Medicaid patients, especially considering the pediatric population is highly likely to have families requiring physician services at odd hours.

RB (12/10/2013 at 9:20 PM)
When can doctors who take care of Medicaid patients, and not so much Medicare (think Pediatricians) get the same opportunity?

Kathy Johnson (12/5/2013 at 1:55 PM)
Can Rural Health Clinics that are paid by face to face encounters, now bill the non-face to face visits with the Gcode???