Medicare Physician Payment Changes: 2011 Conversion Factor (January 2010)

Why This Topic Matters

These updates affect Medicare reimbursement, incentive eligibility, and fee schedule calculations across multiple services and specialties. Understanding the scope of the changes helps practices anticipate payment shifts and related reporting requirements.

Article Sections

1. January 2011 pages 3-5

   The opening identifies the publication context and introduces the article’s focus on Medicare physician payment policy for 2011.

2. Coding Changes and Work Relative Values

   This section summarizes relative value update activity, including CMS review of work, practice expense, and liability-related recommendations across selected services.

3. Potentially Misvalued Services

   This section describes the screening framework used to identify services for revaluation and the broader redistribution concept tied to those reviews.

4. Practice Expense Relative Values

   This section addresses updates to practice expense methodology, survey-based data transitions, and equipment utilization assumptions used in fee schedule calculations.

5. Geographic Practice Cost Indices

   This section covers scheduled geographic index updates and legislation affecting payment floors in selected localities.

6. Rebasing and Revising of the Medicare Economic Index

   This section explains the Medicare Economic Index revision and its effect on the components used in physician payment calculations.

7. Incentive Payments to Primary Care Practitioners for Primary Care Service

   This section discusses primary care incentive eligibility, covered provider groups, and the types of services associated with the incentive program.

8. Incentive Payments for Major Surgical Procedures in Health Professional Shortage Areas

   This section outlines incentive payment policy for qualifying surgical services performed in shortage areas and mentions related modifier development.

9. Preventive Services

   This section reviews Medicare preventive service coverage changes, including wellness-related services and cost-sharing changes.

10. Physician Quality Reporting System

    This section summarizes quality reporting incentive and penalty timing, reporting thresholds, and eligible reporting arrangements.

11. Electronic Prescribing

    This section covers the e-prescribing incentive program, reporting requirements, and the timeline for future penalties.

12. Multiple Procedure Payment Reduction Modifications

    This section discusses Medicare policy changes affecting multiple procedure payment reductions for therapy and imaging services.