MGMA Regulatory Analysis: 2020 Medicare Physician Fee Schedule and MIPS/APMs Proposals

Medical Billing

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MGMA has developed a member-exclusive comprehensive analysis of the 2020 Medicare physician fee schedule proposed rule, which includes changes to the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) policies. This is your definitive resource for understanding how potential changes to Medicare quality reporting and payment policies in 2020 may impact your practice. The analysis includes a review of policy proposals that would:

  • Establish a conversion factor (i.e., the amount paid per relative value unit under the fee schedule) of $36.089;
  • Revise documentation, billing, and payment for Medicare E/M services starting in CY 2021;
  • Increase payment for transitional care management services; and
  • Set reporting criteria to earn a bonus and avoid a payment cut under MIPS.
MGMA will submit detailed comments to the Centers for Medicare & Medicaid Services (CMS) in response to the proposed rule. The final rule is expected this November.


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