New Cods Little Help in Raising Pay, FP Charges

Medicare understands the value of primary care, but the process of increasing payments to such providers may be more difficult than the program realizes, a former head of the American Academy of Family Physicians said here.

The Centers for Medicare and Medicaid Services (CMS) has for the last 2 years introduced new payment codes to reward services unique to primary care -- a sign these agencies realize the value of primary care.

But the process has been difficult for providers to implement. Even 8 months after the introduction of transitional care management code, CMS, AAFP and other primary care organizations are still explaining what qualifications providers need to meet in order to receive the payment.

"I just think they don't recognize how difficult it is to meet all the bullet points," Glen Stream, MD, immediate past AAFP board chair, told MedPage Today. "It's a big leap for them to create new codes."

The final rule on the 2014 fee schedule is due Nov. 1, and AAFP leadership hopes CMS'proposed complex care management codes are easier to implement than this year's transition management.

But as AAFP and organizations like it try to narrow the gap in payment between primary care providers and their specialist counterparts, Stream said lobbying for billing codes unique to primary care is a relatively new strategy.