American Academy of Family Physicians criticizes Centers for Medicare and Medicaid Services fee schedule

February 25, 2011

CMS is coming under harsh criticism from the AAFP for not doing more to ensure that primary care doctors are appropriately valued and reimbursed.

The Centers for Medicare and Medicaid Services (CMS) is coming under harsh criticism from the American Academy of Family Physicians (AAFP) for not doing more to ensure that primary care doctors are appropriately valued and reimbursed.

Lori Heim, MD, AAFP board chairwoman, wrote in a letter to CMS that primary care doctors are being sold short for the work involved in counseling patients for combination vaccinations, because the relative value units are taken from old CPT coding structures that don't reflect the work associated with counseling. The American Medical Association/Specialty Society Relative Value Update Committee has recommended higher values to these codes.

Three new CPT codes allow primary care doctors to be reimbursed for subsequent observation services in a facility setting but do not go far enough to reflect the recent increase in the need for such services, Heim writes.