Physician Reimbursement is More Than Correct Coding

ACOG’s Health Economics & Practice Management Department has a well-established reputation in the physician community as experts in medical coding. Our staff of certified professional billers are readily available to Fellows to answer specific questions on obstetric and gynecologic outpatient and facility medical billing, and the popular Coding Workshops taught by ob-gyn practice managers highlights the commitment ACOG makes to supporting our Fellows in practice.

However, physician payment is so much more. While the national headlines depict a critical and dire scenario for physician reimbursement, ACOG is fervently working to protect Fellows’ bottom line.

ACOG is expanding our regulatory footprint throughout the federal government; in particular, the Centers for Medicare & Medicaid Services (CMS). While the AMA manages coding development and relative-value units (RVUs) assigned to the procedure codes, CMS makes the final determination of value through the annual Medicare Physician Fee Schedule (MPFS). Even if a physician does not provide services to Medicare beneficiaries, they are directly affected by the decisions at CMS. About 80% of the Medicaid reimbursement rates are based on the MPFS, and private insurers typically refer to the national rates to determine their contracted amounts.

With that in mind, ACOG policy analysts and lobbyists have meetings scheduled early this year with CMS, Congress, and physician society partners to discuss 2021 payment and policies related to reimbursement rate updates, obstetric and surgical global payment code, surprise billing, and more.

ACOG strives to support ACOG Fellows with sustainable physician payment and reduced administrative burden. Stay tuned for opportunities to engage in these efforts. It’s your payment we are fighting for!