AMA CPT® Assistant - 1996 Issue 12 (December)
1997 Medicare Payment Policy Changes Affecting Coding (December 1996)
December 1996 pages 1-4 1997 Medicare Payment Policy Changes Affecting Coding On November 22, 1996, HCFA (the Health Care Financing Administration) published in the Federal Register the Final Rule , which contained the 1997 Medicare physician payment schedule, the 1997 relative value units, and several payment policy changes. This Federal Register also announced the 1997 conversion factors (see table on page 2 ). The Final Rule represents the completion of Medicare's first comprehensive five-year review of the RBRVS. The results indicate that the five-year review was very successful in addressing many of the long-standing concerns about the accuracy of the...
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Article Overview
This December 1996 article reviews Medicare payment policy changes released by HCFA for 1997 and explains how they affect physician coding and billing. It covers the shift from certain CPT services to HCPCS Level II reporting, updates tied to relative value changes, and other payment policy revisions affecting Medicare reimbursement. The piece is aimed at physicians, coders, billers, and practice administrators who need to track Medicare-specific coding changes for 1997.
Why This Topic Matters
It helps readers understand which Medicare payment policy changes may alter how services are reported and reimbursed, especially where HCPCS Level II reporting replaced existing CPT reporting. The article is relevant for updating practice workflows, code libraries, and Medicare billing procedures for the 1997 cycle.
Article Sections
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December 1996 pages 1-4
Introductory publication context for the article and its Medicare policy update focus.
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1997 Conversion Factors
Overview of the Medicare physician payment conversion factors announced for 1997.
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Key Policy Changes
Summary of broad HCFA payment policy changes affecting Medicare reporting and reimbursement categories.
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Psychotherapy
Discussion of Medicare reporting changes affecting psychotherapy services and related service categories.
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Care Plan Oversight
Discussion of reporting changes for care plan oversight services and the service settings involved.
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Destruction of Benign or Premalignant Skin Lesions
Overview of Medicare reporting changes for destruction of skin lesions and the affected service family.
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Bone Mineral Density Studies
Coverage and reporting updates for bone mineral density studies under Medicare.
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Other Changes From HCFA In 1997
Additional Medicare payment and coverage changes, including locality, diagnostic test, and bundled payment updates.
What You Will Learn
- How HCFA’s 1997 Medicare payment rule affected physician coding.
- Which broad service areas were subject to reporting changes for Medicare.
- What categories of Medicare payment policy updates were announced for 1997.
- How the article organizes changes affecting psychotherapy, care plan oversight, skin lesion destruction, and bone mineral density studies.
- What additional payment and coverage policy changes were highlighted for Medicare providers.
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Practice administrators
- Compliance staff
- Healthcare reimbursement professionals
Codes Discussed
Code Ranges Discussed
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