Oplinc Best Practices Review, Volume 11, Issue 1

On October 30, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final rule updating payment rates and quality provisions for services provided under the Medicare Physician Fee Schedule (PFS).

The 2016 PFS final rule is the first PFS final rule since the repeal of the Sustainable Growth Rate (SGR) formula, and as such it includes provisions reflecting the mandate for CMS to move to a system that is increasingly based on payment for quality and cost of care rather than the traditional fee-for-service methodology.



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