The Society of General Internal Medicine (SGIM) applauds the Centers for Medicare & Medicaid Services (CMS) for making significant improvements to the payment and documentation requirements for evaluation and management (E/M) services in the CY 2020 Physician Fee Schedule final rule.
SGIM has actively advocated on this issue and founded the Cognitive Care Alliance (CCA) in 2015 in order to urge CMS to ensure these services recognize the complex work primary care and other cognitive physicians provide to patients. Through SGIM's work with the CCA, the Society has highlighted that the undervaluation of E/M services has not just resulted in a primary care workforce shortage, but also shortages in other internal medicine subspecialties that primarily bill E/M services.
The E/M changes in the final rule represent an important first step to addressing these workforce shortages and protecting patient access to E/M services. However, SGIM believes more work needs to be done before these codes fully capture the complex care delivered by members. "A strong primary care system has been shown to improve patient outcomes and reduce costs, but Medicare has undervalued these services. SGIM is pleased that CMS finalized E/M changes that will more appropriately recognize the care our members deliver to patients, some with multiple chronic conditions that may require multiple interacting medications to stay healthy. The Society will continue to advocate for additional improvements in the E/M code family in order to enhance delivery of the comprehensive care patients need," said Eric Bass, MD, MPH, FACP, SGIM Chief Executive Officer.
SGIM will continue to work with CMS and members of Congress to ensure this policy is implemented as finalized in CY 2021 and additional refinements are made to protect patient access to primary care services.