2009 Physician Fee Schedule Rule Addresses Anti-Markup, Stark, IDTF, And Other Issues

Why This Topic Matters

The rule affects how multiple Medicare payment and compliance areas are administered, so organizations that bill Medicare or manage physician practices may need to review the changes for operational impact and effective dates.

Article Sections

1. Introduction

   Overview of the 2009 Final Physician Fee Schedule Rule and the major Medicare policy areas it addresses.

2. The Anti-Markup Rule for Diagnostic Tests

   Discussion of CMS revisions to the anti-markup framework for diagnostic testing and the alternative compliance approaches described in the rule.

3. Physician Self-Referral (Stark Law)

   Summary of Stark Law-related updates, including postponed exception finalization and conforming regulatory changes tied to therapy service definitions.

4. IDTFs

   Coverage of enrollment-related issues for independent diagnostic testing facilities and related diagnostic testing standards.

5. Mobile Diagnostic Testing

   Explanation of Medicare enrollment and billing requirements discussed for mobile diagnostic testing entities.

6. Exemption From E-Prescribing Standards for Computer-Generated Facsimile Transmissions

   Review of changes affecting electronic prescribing standards and the temporary status of fax-based prescription transmission.

7. Electronic Prescribing Incentive Program

   Overview of the incentive program for successful electronic prescribers and the general eligibility framework described in the rule.

8. Services Furnished by ESRD Facilities

   Discussion of ESRD payment policy changes, updates tied to federal legislation, and comments on hospital-acquired condition policy issues.

9. Payment Level Changes

   Brief summary of the overall Medicare payment update for covered practitioners under the fee schedule.

10. Practice Expenses and Relative Value Units

    Coverage of practice expense methodology, AMA survey data, and code-related updates affecting physician service valuation.

11. Medicare Telehealth Services

    Discussion of telehealth service categories considered by CMS and the planned addition of coding for follow-up inpatient telehealth consultations.

12. Specific Coding Issues Related to Physician Fee Schedule

    Summary of coding-related changes within the physician fee schedule, including imaging payment reduction updates and other procedure code revisions.

13. Physician and Non-Physician Practitioner Enrollment

    Explanation of enrollment effective-date rules and reporting obligations for practitioners and practitioner organizations.

14. Changes to Ambulance Beneficiary Signature Requirements

    Review of documentation requirements and signature-related changes affecting ambulance claims for emergency and non-emergency transports.