Pray for Pay


This is from the Family Medicine SmartBrief:

The AAFP asked the CMS for additional information on some new codes contained in the 2015 Medicare physician fee schedule because the agency failed to provide relative value units for them. The AAFP letter noted that even though Medicare does not recognize the 99487 code for complex chronic care management services, it should publish the RVUs related to it because other insurers may recognize the code.

The link is broken (and so is the AAFP) so I cannot send you to this reference.  Here are some thoughts.  How weak is the AAFP?  I am so confused. The whole “complex chronic care” trend is not recognized by Medicare?  Someone explain this to me.  Isn’t the whole PCMH or ACO or whatever built on this concept? And the best that the AAFP can do is pray that if the RVUs are published that maybe an insurer will cover it.  Yeah, good luck with that.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Pray for Pay

  1. gene
    December 24, 2014 at 9:20 am

    Wake up and eliminate the middle man. Stop accepting insurance.

  2. R Watkins
    December 23, 2014 at 1:18 pm

    Pray for pay: I like it. I’m going to steal it.

    Nothing better illustrates the utter idiocy and/or total maliciousness of those pushing the PCMH: the idea that physicians should invest the time, personnel and money in providing services for free (no contract or fee schedule), and then hope, wish, pray that insurers, out of the kindness of their hearts, will begin to pay for them.

    A decade later, may practices are still waiting.


  3. Pat
    December 23, 2014 at 1:00 pm

    ‘Oliver Twist’ and his begging bowl, asking for more gruel would make a great AAFP mascot.

    • Doug Farrago
      December 24, 2014 at 8:36 am

      I LOVE IT!!!!

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