Out of the blue comes a volley of idiocy from the Centers for Medicare and Medicaid (CMS) with a new proposed rule that, among other things, would require podiatrists to use different evaluation and management coding from other physicians with a lower reimbursement amount.

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This proposed change is outrageous and discriminatory.

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Here’s the very basic and boiled down explanation. For those interested, read the full 1472 page proposal here (we have highlighted all sections relevant to podiatrists).

According to the proposal, “The single payment rate for E/M code levels 2 through 5 would benefit podiatry the most because, due to the nature of most podiatric E/M visits, they tend to bill only level 2 and 3 E/M visits.” This is a complete falsehood. Many podiatric patients require higher levels of E/M coding due to the same complex medical conditions that their other physicians are treating. Are you telling me that an orthopedic foot and ankle surgeon seeing a diabetic patient pending a Charcot reconstruction (who would now code under the new proposed rules along with all other physicians) should code a higher E/M code and should receive more reimbursement? Absolutely not. This is the same patient with the same complex medical conditions, requiring the same treatment. It’s simply discriminatory to assume podiatrists don’t practice the same medicine as everyone else.

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“It’s simply discriminatory to assume podiatrists don’t practice the same medicine as everyone else.”

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Additionally, podiatrists stand to lose – not make - money in comparison with other medical specialties. According to this very report, “The estimated impacts for several specialties, including allergy/immunology, diagnostic testing facilities, hematology/oncology, radiation therapy centers, and podiatry, reflect decreases in payments relative to payment to other physician specialties” (pg. 1026).

Podiatrists are recognized by Medicare as physicians, but adoption of this proposal will serve to separate us from the other medical professions, creating an underclass where we are devalued by the government: separate and not equal. This is an intolerable situation and threatens our profession. Simplifying medical billing is one thing, but creating a medical apartheid is another.

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“Adoption of this proposal will serve to separate us from the other medical professions, creating an underclass where we are devalued by the government: separate and not equal”

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The American Podiatric Medical Association (APMA) has a good explanation of these proposals here

The section in the executive summary that pertains specifically to separating out podiatrists is located on page 344 of the proposal. We have highlighted all sections relevant to podiatrists.

I urge all of you to communicate your disagreement with this proposal. Follow the APMA’s lead by reading the section below straight from the APMA information email:

WHAT YOU CAN DO:

APMA makes it very easy to contact your U.S. Congressional Representative and voice your disagreement with this proposed policy change. Go to the APMA eAdvocacy website by clicking HERE to access a pre-drafted comment letter to CMS. You are welcome to add any additional constructive thoughts you have. Comment letters MUST be submitted by September 10, 2018. This will, literally, take you less than 5 minutes to do. EVERY podiatrist and their families should do this immediately!

Please share the following link with your patients, family, and friends: https://www.apma.org/eadvocacy

HOW TO FIND YOUR MEMBERS OF CONGRESS:

If you want to be treated like less than other doctors and abrogate all of the progress we have made as a profession, then, by all means, do nothing. If you want to be treated like other physicians, then follow the directions above and communicate your disagreement with this proposal. Don’t let others determine our future.