decisionhealth Newsletters, Coder Pink Sheets - 2007 Issue 12 (December)
Calculate the impact of Medicare fee changes on your interventional practice
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Article Overview
This article is aimed at interventional practices, coding staff, and practice administrators who need to estimate the financial effect of Medicare physician fee schedule updates for a new payment year. It covers a step-by-step approach for comparing projected fee changes, including the roles of RVUs, geographic adjustments, and the conversion factor, and it points readers to CMS resources for preparing revenue projections before the final fee schedule is posted.
Why This Topic Matters
Medicare payment changes can affect procedure-level revenue in different ways depending on geography, RVU updates, and conversion factor changes. Understanding these factors helps practices forecast impact, plan budgets, and prepare for operational decisions without waiting for the final fee schedule.
Article Sections
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Overview of Medicare fee changes
Introduces the anticipated Medicare physician fee schedule changes and the reasons practices may need to model more than one payment outcome.
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Five steps to a clearer picture
Outlines a workflow for estimating the effect of fee schedule changes on a practice’s highest-volume procedures and projected revenue.
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Resource
Points readers to CMS materials for downloading RVU and geographic practice cost index data.
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How to calculate your 2008 Medicare fees
Summarizes the components used in the fee calculation, including RVU categories, geographic adjustments, and the conversion factor.
What You Will Learn
- How to estimate the impact of Medicare physician fee changes on interventional services
- How RVUs and geographic indices factor into payment projections
- How to use CMS data to model practice revenue changes
- How to compare projected reimbursement under different fee schedule assumptions
Who Should Read This
- Interventional radiology practices
- Physician coders
- Coding managers
- Practice administrators
- Revenue cycle staff
Codes Discussed
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