BC Advantage - 2010 Issue 11
Highlights of the proposed rule for the 2011 Physician Fee Schedule
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Article Overview
This article summarizes major topics from CMS’s proposed 2011 Physician Fee Schedule rule and explains why providers should review the rule and consider submitting comments. It is aimed at physicians, coders, and practice administrators who need a high-level view of proposed Medicare payment and coverage changes, including imaging and therapy payment policy, diabetes self-management training RVU updates, telehealth eligibility considerations, and a new annual wellness visit benefit.
Why This Topic Matters
The proposed rule could affect Medicare reimbursement, service coverage, and practice operations for multiple specialties. Understanding the broad areas under review helps practices evaluate potential impacts and decide whether to comment during the rulemaking period.
Article Sections
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Introduction and rulemaking context
Provides background on the CMS proposed rule process and the purpose of reviewing selected highlights from the 2011 physician fee schedule proposal.
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Expansion of the Multiple Procedure Payment Reduction for additional nonsurgical services
Discusses proposed changes related to multiple procedure payment reduction policy and broader payment-efficiency concepts affecting certain service groupings.
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Expansion of the Multiple Procedure Payment Reduction policy to include therapy services
Summarizes the proposed application of multiple procedure payment reduction concepts to therapy services and related reimbursement considerations.
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Other therapy issues
Reviews additional therapy-related policy discussion in the proposed rule, including alternatives to existing payment limitations.
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Diabetes Self-Management Training (DSMT) services
Addresses proposed relative value updates for diabetes self-management training services and references related Medicare billing codes.
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Consideration for adding several services to the list of Medicare telehealth services
Outlines the types of services under consideration for possible inclusion on the Medicare telehealth list across several clinical areas.
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Coverage of annual wellness visit
Summarizes the proposed new preventive benefit and its intended role within Medicare coverage.
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Comment submission and closing reminders
Provides general guidance on the public comment timeline and where comments on the proposed rule could be submitted.
What You Will Learn
- The main policy areas addressed in CMS’s proposed 2011 Physician Fee Schedule rule
- How the article frames potential payment changes affecting imaging, therapy, and preventive services
- Which service categories were being considered for expanded Medicare telehealth coverage
- What the article says about the proposed annual wellness visit benefit
- Why provider feedback during the comment period was encouraged
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice administrators
- Compliance professionals
- Healthcare consultants
Codes Discussed
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