News from the AGA

Win! CMS to pay for phone visits same as in-person appointments


 

Since the beginning of the pandemic, AGA has objected to the Centers for Medicare & Medicaid Services’ (CMS) low reimbursement rate for evaluation and management (E/M) services provided by telephone. Today, CMS fixed the problem. Retroactive to March 1, 2020, CMS will pay E/M services provided by telephone at the same rate as in-person, office/outpatient E/M services.

Thanks to everyone who helped us push CMS to address this issue. AGA worked together in coalition with other specialties and Congress on resolving this problem from the start of the pandemic.

Here are more details:

  • Medicare’s updated guidance to physicians states, “Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.
  • The CMS press release outlined the new rates for telephone E/M:
  • CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.

We are pleased CMS listened to our message and has addressed this issue. Join the discussion on the AGA Community.

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