Backlash against the ridiculous idea of blended payment rates:

“Paying a blended rate (an average of several CPT codes determined by the health plan) for Levels 3, 4 and 5 office visits contradicts the concept of a resource-based relative value scale upon which the Medicare rates are based,” said the letter. Higher-level office visits cost more for a reason: Not only does the physician spend more time taking the patient’s history and completing the medical exam, he or she performs at a higher level of decision making, continued the letter.

“Medicare, the largest payer in the United States, recognizes and pays more for the higher levels of office visits on this basis, and we believe CIGNA HealthCare should, too,” said the letter.