Conversion factor for 2007 set at $35.9848

Why This Topic Matters

The 2007 fee schedule and related CMS rules affect reimbursement, coverage, and billing for a wide range of professional and facility services. Understanding the scope of these updates helps organizations assess payment impacts and identify services touched by policy revisions before implementation.

Article Sections

1. 2007 physician fee schedule overview

   An overview of the final 2007 Medicare physician fee schedule and its effective date. The section frames the major payment and policy themes addressed in the report.

2. Relative Value Units

   Discussion of work RVU revisions, budget neutrality adjustments, and related practice expense and E/M payment themes. The section also summarizes review activity affecting selected services.

3. Diagnostic, clinical testing

   Coverage and billing policy updates affecting independent diagnostic testing facilities, clinical laboratory services, pathology, laboratory quality, and selected testing services. The section also covers certain service-specific payment changes.

4. Health Information Technology

   CMS positions on health IT adoption, transparency initiatives, and related reporting and information-sharing efforts. The section addresses broader policy direction rather than individual code-level edits.

5. Screening and preventative services

   Updates to Medicare coverage and payment for preventive and screening services, including beneficiary cost-sharing and eligibility-related changes. The section includes several service-specific preventive care policies.

6. Ambulatory Surgery Centers

   Changes affecting ASC-covered procedures, payment methodology timing, beneficiary copayments, and new technology devices. The section summarizes list expansions and payment structure issues.

7. Geographic Price Cost Index

   Information on the revaluation of geographic price adjustments and the status of floor provisions affecting local payment variation. The section focuses on geographic payment methodology.

8. Cardiac cath codes

   Policy updates affecting cardiac catheterization-related payment methodology and temporary pricing treatment for selected imaging and monitoring services. The section also notes carrier pricing issues for certain procedures.

9. Code changes

   A group of service-specific revisions affecting hospice, home health, brachytherapy, imaging, FQHC, endovenous, and related procedures. The section summarizes multiple code-level payment and billing changes.

10. Drugs

    Medicare Part B drug payment policy updates, including average sales price treatment, service fee concepts, IVIG payment, and SGR-related drug issues. The section addresses drug reimbursement methodology.

11. Non-physician practitioner services

    Policy items affecting non-physician practitioner certification, chiropractic demonstration considerations, and therapy caps. The section covers practitioner services and benefit limits.

12. Miscellaneous

    Additional Medicare payment and compliance topics, including bad debt, ambulance fee schedule handling, self-referral, SGR-related concerns, practice expense assumptions, and reassignment access rules. The section gathers broader administrative updates.

13. 21 services added to ASC list for 2007

    A table listing additional services approved for ASC performance and associated facility fee information. This section presents the added procedures as a reference list.

14. Impact on Medicare charges by specialty

    A table summarizing projected Medicare payment impacts by specialty under the final 2007 physician fee schedule. The section provides specialty-level distribution information.