Enhanced reimbursement is becoming a reality.

Physicians' cognitive services, historically underpaid in comparison to specific procedures, are finally beginning to earn deservedly higher fees. To a great extent, this increased reimbursement is the result of action by the American Society of Internal Medicine. The authors note how some HMOs and insurers are already implementing payments for cognitive services, and a Table outlines congressional action in this direction from late 1983 to the present. Suggestions are given for changes individual physicians can make in their practices so that they can emphasize these services. The authors also describe the objectives of the ongoing, federally funded, Harvard Relative Value Scale.