decisionhealth Newsletters, Part B News - 2009 Issue 11 (November)
Final 2010 fee schedule dominated by consult change, 21.2% cut
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Article Overview
This article reviews the final 2010 Medicare Physician Fee Schedule and highlights the broad policy changes most likely to affect physician practices. It is aimed at coders, billing staff, practice managers, and reimbursement professionals who need to track Medicare payment updates, changes affecting evaluation and management reporting, relative value unit revisions, and quality reporting program updates. The discussion focuses on the general scope of the fee schedule changes and their operational importance without serving as a detailed coding guide.
Why This Topic Matters
Understanding the final fee schedule helps practices anticipate payment changes, prepare for the elimination of consultation coding, and track updates that may affect reimbursement and reporting workflows.
Article Sections
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Payment update and conversion factor changes
Overview of the 2010 Medicare Physician Fee Schedule payment update and the conversion factor change affecting physician reimbursement.
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Consults now extinct
Discussion of CMS’s decision regarding consultation services and the shift in reporting approach for affected professional services.
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Drugs removed from payment calculations
Explanation of changes to how physician-administered drugs are handled in the sustainable growth rate framework and why the update matters over time.
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A mixed bag for RVU changes
Summary of relative value unit revisions, including practice expense methodology updates and the transition to a new survey-based data source.
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PQRI expanded, improved
Review of changes to the Physician Quality Reporting Initiative, including expanded measure options and electronic reporting developments.
What You Will Learn
- How the 2010 Medicare Physician Fee Schedule affects physician payment updates
- What broad changes were made to consultation reporting
- How drug payment treatment factors into broader Medicare payment policy
- What kinds of RVU methodology changes were introduced
- How PQRI reporting options were expanded for 2010
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Practice managers
- Physician offices
- Revenue cycle professionals
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