decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 12 (December)
Your 2011 conversion factor: $25.5217 if Congress doesn’t fix SGR
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Article Overview
This article explains the 2011 Medicare physician fee schedule and related payment policy changes released by CMS. It is aimed at physicians, coders, billing staff, and practice administrators who need to understand how federal payment updates may affect reimbursement across specialties and service categories. Coverage includes the conversion factor timeline, relative value unit impacts, selected bonus provisions, annual wellness visit reporting, therapy payment reductions, and imaging-related fee schedule changes.
Why This Topic Matters
The article helps readers track federal Medicare payment changes that may affect reimbursement planning, specialty-specific revenue expectations, and reporting for new or revised services in 2011.
Article Sections
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Fee schedule overview and conversion factor changes
Summarizes the overall Medicare physician fee schedule update and the projected changes to physician payment levels over the transition period.
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Specialty impacts and RVU changes
Describes projected relative value unit trends across major specialties and the general direction of payment effects by service type.
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Policy changes
Introduces the main policy updates included in the final fee schedule that affect different types of physician and non-physician services.
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General surgery HPSA bonuses
Covers the high-level bonus policy related to services furnished in designated shortage areas and the affected provider group.
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Primary care bonuses
Summarizes the broad eligibility framework for primary care payment incentives and the categories of practitioners involved.
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Annual wellness visits
Describes the addition of new reporting options for wellness visit services and the general valuation context for those services.
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Therapy service reductions
Explains the therapy payment reduction policy affecting multiple services furnished on the same date by a single provider.
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Imaging fee cuts
Reviews the imaging-related practice expense changes and the broader impact on advanced diagnostic services.
What You Will Learn
- How the 2011 Medicare physician fee schedule affects payment levels overall
- Which broad specialty groups were projected to experience increases or decreases
- What categories of policy updates were included in the final fee schedule
- How the article frames bonus-related changes for certain physician services
- What general types of changes were made for wellness visits, therapy, and imaging
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice administrators
- Revenue cycle professionals
Codes Discussed
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