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CMS Proposes Changes That Could Impact Pediatric Billing
CMS recently released the proposed Calendar Year 2027 Medicare Physician Fee Schedule, which includes several proposals that may be of interest to pediatric practices.
While these policies apply directly to Medicare, commercial payers often follow Medicare's lead when implementing reimbursement changes.
Two proposals of particular interest include:
Potential reduction in reimbursement for combined well and sick visits
CMS is proposing changes that could limit payment for a sick visit performed in conjunction with a preventive visit to 50% reimbursement.
Changes to HCPCS code G2211
CMS has also proposed converting HCPCS code G2211 from a standalone code to a modifier.
Practices may wish to monitor these proposals closely, as future commercial payer policies could be influenced by the final rule.
Learn more: Calendar Year 2027 Medicare Physician Fee Schedule Proposed Rule | CMS
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