AMA CPT® Assistant - 2010 Issue 1 (January)
Medicare Physician Payment Changes For 2010 (January 2010)
January 2010 pages 3-5 Medicare Physician Payment Changes For 2010 Conversion Factor As of December 17, 2009, Congress has passed legislation to apply a zero percent update to the conversion factor through February 28, 2010. The American Medical Association (AMA) is working on a permanent repeal of the subtainable growth rate (SGR). The AMA believes that annual short-term fixes to the annual conversion factor have exacerbated the problem. In 2005, the Congressional Budget Office (CBO) indicated that freezing physician payments would cost $48.6 billion over 10 years, and now in 2009 the CBO estimates the cost at $210...
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Article Overview
This article summarizes major 2010 Medicare physician payment changes and the policy updates behind them. It covers fee schedule updates, valuation and practice expense methodology changes, consultation service changes, quality reporting, and ePrescribing program updates. It is relevant for physician practices, coders, billers, compliance staff, and others tracking CMS payment policy and CPT-related changes.
Why This Topic Matters
The 2010 Medicare payment year included multiple changes that could affect coding, reporting, and reimbursement across many specialties. Understanding the scope of these updates helps practices monitor fee schedule impacts and reporting requirements.
Article Sections
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Conversion Factor
Discusses Medicare physician payment update policy and the broader legislative and administrative context for the 2010 fee schedule.
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Coding Changes and Work Relative Values
Summarizes CPT code review activity, CMS payment policy actions, and RUC-related valuation work for 2010.
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Soft Tissue Tumor/Bone Tumor Services
Covers specialty society and CMS review activity related to selected procedural families within the CPT framework.
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Bundled Services
Describes selected service groupings reviewed for bundling within the 2010 coding cycle and their relation to payment policy.
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Potentially Misvalued Services
Reviews the ongoing identification process for services targeted for valuation review and the screening approaches used.
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Practice Expense (PE) Relative Values
Explains CMS practice expense methodology changes, survey data use, and equipment utilization assumptions affecting 2010 payment values.
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Professional Liability Insurance (PLI)
Summarizes the update process for malpractice-related relative values and the data sources used for 2010.
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Geographic Practice Cost Indices (GPCIs)
Describes updates to geographic adjustment factors and related statutory changes affecting locality-based payment calculations.
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Consultation Services
Covers changes affecting consultation service reporting and the redistribution of payment impacts to related visit services.
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Physician Quality Reporting Initiative (PQRI)
Summarizes the 2010 PQRI reporting framework, participation options, and program enhancements.
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ePrescribing Incentive Program
Reviews the 2010 reporting and participation changes for the Medicare ePrescribing incentive program.
What You Will Learn
- How the 2010 Medicare physician fee schedule was adjusted
- What categories of CPT and CMS valuation changes were addressed
- Which CMS reporting programs were updated for 2010
- How practice expense, PLI, and geographic adjustments were revised
- What broad policy areas were highlighted for physician payment planning
Who Should Read This
- Physician coders
- Medical billers
- Practice administrators
- Compliance staff
- Physicians
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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