decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 12 (December)
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Article Overview
This article explains how a cardiology practice can review upcoming Medicare physician fee schedule changes and estimate the financial effect on its highest-volume services. It is aimed at practice administrators, coders, and billing staff who need to understand broader fee schedule updates, RVU shifts, geographic adjustments, and CMS-published conversion factors. The article covers a practical workflow for comparing scenarios and preparing for possible policy changes.
Why This Topic Matters
Medicare fee schedule updates can change practice revenue materially, especially for high-volume cardiology services. Understanding the general impact of RVU and conversion factor changes helps practices plan ahead and evaluate reimbursement trends.
Article Sections
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Medicare fee schedule changes and practice impact
Introduces the fee schedule changes affecting cardiology practices and explains the need to evaluate more than one possible payment scenario. The discussion focuses on broad reimbursement components and planning implications.
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High-volume cardiology services to review
Identifies example cardiology services commonly used for revenue impact review. The section frames which categories of services may be most important to analyze first.
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Five steps to a clearer picture
Outlines a multi-step approach for estimating the effect of fee schedule updates on practice revenue. The section covers the use of CMS-published data, comparison methods, and projection of overall financial impact.
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How to calculate your 2008 Medicare fees
Presents the general calculation framework used to estimate Medicare fees from the published fee schedule inputs. The section summarizes the components needed to build a locality-adjusted payment estimate.
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Resources
Points readers to CMS source material and related downloadable reference files. The section supports further review of the underlying fee schedule data.
What You Will Learn
- How Medicare fee schedule changes can affect cardiology practice revenue
- How to review RVU and geographic adjustment data at a high level
- How to compare different payment scenarios for planning purposes
- How to use CMS-published fee schedule resources for fee estimation
- How to estimate the financial effect of upcoming reimbursement changes
Who Should Read This
- Cardiology practices
- Practice administrators
- Medical coders
- Billing staff
- Revenue cycle personnel
Codes Discussed
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