decisionhealth Newsletters, Part B News - 2011 Issue 7 (July)
E/M codes win, imaging loses under continuing transition to new dataset
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Article Overview
This article explains the ongoing Medicare Physician Fee Schedule transition from older survey data to PPIS-based practice expense RVUs and describes how the proposed 2012 update is expected to affect payment patterns across specialties. It is relevant to coders, billers, and reimbursement professionals who need to understand broad fee schedule trends, specialty impact, and the Medicare context behind shifting relative value units.
Why This Topic Matters
The article helps readers understand why some service categories are projected to gain while others are projected to lose under the evolving Medicare payment methodology. That context matters for planning, specialty financial analysis, and monitoring changes tied to the 2012 PFS and the later full PPIS implementation.
Article Sections
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Medicare PFS transition and payment trend overview
Introduces the proposed 2012 Medicare Physician Fee Schedule and the broader shift in practice expense RVU methodology. Summarizes the general payment pattern affecting different service categories and specialties.
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Specialty impact and stakeholder perspectives
Describes how various medical specialties are affected by the transition and summarizes viewpoints from professional associations and payment policy representatives. Includes discussion of the planned move toward full PPIS use.
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RVU and payment changes for top imaging codes, 2009-2013
Presents a comparison of payment trends for selected imaging services over multiple years under the evolving fee schedule methodology. The section focuses on the article’s table of imaging-related billing codes and payment changes.
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RVU and payment changes for top E/M codes, 2009-2013
Presents a comparison of payment trends for selected evaluation and management services over multiple years under the evolving fee schedule methodology. The section focuses on the article’s table of office visit billing codes and payment changes.
What You Will Learn
- How the Medicare Physician Fee Schedule transition affects relative value unit calculations
- Which broad specialty groups are seeing projected payment increases or decreases
- How the article frames the differences between imaging services and evaluation and management services
- What years and payment periods are compared in the article’s summary tables
- How the PPIS transition is discussed in relation to Medicare reimbursement trends
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Reimbursement analysts
- Physician groups
- Health policy professionals
Codes Discussed
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