Each year, the Centers for Medicare & Medicaid Services (CMS) publishes proposed and final rules for changes to the Medicare Physician Fee Schedule (MPFS). Why should pediatricians pay attention to this? The CMS has become a leader (if not the leader) in the payer community in promoting new payment methodologies and increased payment for primary care services. This is especially true for coverage of non–face-to-face services and services performed by clinical staff under physician supervision. New Medicare benefits are often a catalyst for coverage by Medicaid and private payers. The Medicare rationale for coverage also offers a bargaining point in advocacy efforts with other payers.

Some highlights of the MPFS changes for 2017 are

In this issue of AAP Pediatric Coding Newsletter™, we will review coding for non–face-to-face prolonged services (99358, 99359) and complex chronic care management services (99487, 99489), including some nuances...

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