decisionhealth Newsletters, Part B News - 2011 Issue 1 (January)
2011 conversion factor falls, but RVU changes prop up your payments
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Article Overview
This article reviews 2011 Medicare physician fee schedule payment changes and explains how adjustments to relative value units and the conversion factor affected reimbursement. It is aimed at coders, billers, and practices that need to understand why payment amounts for commonly billed services changed from 2010 to 2011. The article includes a payment-change table, references to CMS implementation timing, and examples from multiple specialties and service types.
Why This Topic Matters
It helps readers interpret Medicare payment fluctuations for 2011 and understand the broader fee schedule changes that influenced reimbursement across many commonly reported services.
Article Sections
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Conversion factor and overall 2011 payment impact
Introduces the 2011 Medicare conversion factor and explains the overall payment environment for the year. Summarizes why many services did not follow the same direction as the conversion factor change alone might suggest.
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RVU adjustments and CMS implementation timing
Discusses the role of relative value unit adjustments in the Medicare physician fee schedule and notes CMS timing for implementing the updates. Mentions the broader fee schedule rescaling context and budget neutrality considerations.
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Examples of code-specific payment changes
Presents selected service examples showing mixed payment effects under the revised fee schedule. Covers several specialties and service categories, including procedures, imaging, office visits, and hospital services.
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Key payment changes for 2011
Provides a table of code-level 2010 and 2011 payment comparisons with associated RVU changes. The table spans multiple services and shows how payment amounts shifted across different clinical areas.
What You Will Learn
- How 2011 Medicare physician fee schedule updates affected payment amounts
- Why a lower conversion factor did not necessarily mean lower reimbursement for every service
- How RVU adjustments can influence payment changes across different types of services
- What kinds of services were highlighted in the 2011 payment comparison table
- How CMS implementation timing fit into the fee schedule update process
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Physician practices
- Compliance staff
- Practice managers
Codes Discussed
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