AMA CPT® Assistant - 2013 Issue 1 (January)
Medicare Physician Payment Changes for 2013 (January 2013)
January 2013 pages 3-5 Medicare Physician Payment Changes for 2013 On November 1, 2012, the Centers for Medicare and Medicaid Services (CMS) released the Final Rule for the 2013 Medicare Physician Payment Schedule (MPFS). Conversion Factor for 2013 The Temporary Payroll Tax Cut Continuation Act of 2011 that was signed on December 23, 2011, provided temporary relief from an impending cut to the Medicare conversion factor, but this provision will expire on December 31, 2012. Accordingly, the CMS will implement a 26.5% decrease to payment effective January 1, 2013, and the projected Medicare conversion factor for 2013 is...
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Article Overview
This article explains the 2013 Medicare Physician Fee Schedule and related CMS updates that affect physician reimbursement, coding valuation, and reporting programs. It is aimed at physicians, coders, billers, compliance staff, and practice administrators who need a high-level understanding of payment policy changes, relative value updates, and incentive and penalty programs. The discussion covers CMS and AMA/RUC involvement, practice expense and geographic index changes, multiple procedure payment reductions, and reporting programs tied to performance and electronic prescribing.
Why This Topic Matters
These updates influence how physician services are valued and paid under Medicare, and they affect documentation, reporting, and practice revenue planning for 2013 and beyond. The article helps readers identify major policy areas that may require operational review without replacing the full premium guidance.
Article Sections
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January 2013 pages 3-5
Introductory publication information and the scope of the article's Medicare payment update coverage.
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Conversion Factor for 2013
Overview of the annual Medicare conversion factor update and related policy context.
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Coding Changes and Work Relative Values
Discussion of CMS, AMA, and RUC activity related to coding valuation, payment implementation, and selected code families.
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Potentially Misvalued Services
Summary of the screening process used to identify services for review and revaluation.
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Practice Expense Relative Values
Coverage of practice expense data, methodology updates, and related valuation adjustments.
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Professional Liability Insurance Relative Values
Brief review of professional liability insurance value updates and future refinement timing.
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Geographic Practice Cost Indices
Discussion of geographic payment adjustments and updates affecting locality-based payment calculations.
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Multiple Procedure Payment Reduction Modifications
Overview of changes to Medicare multiple procedure payment reduction policy across service categories.
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Physician Quality Reporting System
Summary of quality reporting incentives, penalties, and reporting periods affecting 2013 participation.
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Value-Based Modifier
Explanation of the timing and broad structure of the value-based payment adjustment program.
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Electronic Prescribing
Review of the e-prescribing incentive program, reporting expectations, and penalty timing.
What You Will Learn
- How the 2013 Medicare Physician Fee Schedule changed physician payment policy
- Which broad valuation and reporting programs CMS updated for 2013
- How CMS and AMA/RUC processes influenced Medicare payment adjustments
- Which Medicare incentive and penalty programs were tied to 2013 reporting and performance
- What general categories of services and specialties were affected by the article's payment updates
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Practice administrators
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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