Find-A-Code Focus Newsletter

Medicare Payment Increase

By Frank Cohen
July 01, 2015
Medicare Payment Increase
Congress recently updated the Medicare calculations, eliminating the Sustainable Growth Rate (SGR) and the emergency fixes that have been rushed into place each year. Another benefit of the Medicare Access and CHIP Reauthorization Act of 2015 is that the Medicare conversion factor (CF) gets a 0.5% boost for services provided on or after July 1, 2015. 

Hopefully, your practice management system will make it easy to bill Medicare this year – just be sure that:
  • Services provided from January 1, 2015 to June 30, 2015 are billed with a CF of 35.7547
  • Services provided from July 1, 2015 to December 31, 2015 are billed with a CF of 35.9335
Alas, the sequestration order covers payments for dates of service through March 31, 2016, so we have another nine months before Medicare pays the full allowed amount.

If you have any questions, please feel free to contact me.

Frank Cohen

P.S. Just a quick reminder that Thursday, July 2 at 2 pm ET, I am presenting a 30 minute Quickinar™ on the Medicare Provider Utilization and Payment data set to show attendees how to interpret, understand and use the results to assess exposure and potential risk for audit or review. To register, go to Frank Cohen Training and select this session in the list.

Whether you register or not, I invite you to check out your risk scores for the two key metrics we developed from the Medicare data. Go to and select the Medicare Risk link in the "What's New" panel (membership required).


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