Medicare Ready To Pay Primary Care Doctors Same As Specialists

Medicare’s 2018 fee schedule shows the program is increasingly willing to pay primary-care physicians to manage complex patients, a trend that may narrow the pay gap between those physicians and specialists.

Over the years, the Content Management Codes (CMS) billing codes and pilot programs have boosted physicians’ earnings. Whereas treating a complex patient used to net a doctor as little as $10 per month, new billing codes have driven that to as much as $94 this year, according to a new analysis from the Urban Institute.

That’s important because some parts of the country are experiencing primary-care physician shortages, notes the Urban Institute report. Improving income and payment for primary care is going to help attract physicians to this field, concludes the report.





Medicare:  Payment Schedules

Primary-care physicians’ median incomes now range from $225,000 to $250,000. For specialists like cardiologists or orthopedic surgeons, the median is as high as $550,000, according to the study.

Most payments to primary-care physicians are still for old-fashioned, face-to-face visits, but Medicare’s fee schedules have increasingly carved out space for new modes of care delivery. In 2013, for example, the CMS began paying providers to manage care transitions for patients recently discharged from hospitals or other facilities. And in 2015, it began paying doctors to manage patients with multiple chronic conditions, a group that accounts for a disproportionately high amount of Medicare spending.


Medicare: New Fee Schedule

The new 2018 Medicare Physician Fee Schedule will cover remote monitoring of patients’ blood pressure and blood glucose, essentially telehealth. It will pay for telehealth services like caregiver risk assessments. It will also pay to have community health workers help pre-diabetic patients lose weight.

The CMS is modernizing the way it pays for primary care, and the Trump administration is supporting this effort.



Medicare’s increasing the fees to primary care doctors to the level of specialists will attract more doctors to primary care and help hospitals now experiencing primary-care physician shortages. Most important, you, the consumer-patient will benefit from higher quality medical care, and that is a win-win for everyone.

Leave a Comment