decisionhealth Newsletters, Part B News - 2012 Issue 11 (November)
Final 2013 fee schedule released: Physicians paid to coordinate care
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Article Overview
This premium article covers major provisions in the final 2013 Medicare physician fee schedule and explains why the changes matter for physicians, non-physician practitioners, and other billing professionals. It discusses payment updates, care coordination billing, revisions to the value-based payment modifier, changes affecting non-physician practitioner privileges, alignment of Medicare quality and electronic reporting programs, and the durable medical equipment face-to-face requirement. The piece is relevant to coding, billing, compliance, and practice management readers who follow Medicare policy updates.
Why This Topic Matters
The 2013 fee schedule affected Medicare payment, reporting, and practice workflow across multiple provider types. Understanding the scope of these changes helps organizations assess reimbursement impact and prepare for updated compliance and documentation expectations.
Article Sections
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Fee schedule overview and payment updates
Summarizes the major Medicare physician fee schedule changes and overall payment direction for different provider groups.
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New care coordination service
Describes the addition of a new post-discharge transitional care management service and its role in the broader schedule update.
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Value-based payment modifier revisions
Covers changes to the timing and scope of the payment modifier under the Affordable Care Act and how it relates to practice size.
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Non-physician practitioner privileges
Discusses expanded reporting and ordering privileges affecting non-physician practitioners and related provider groups.
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Alignment of incentive programs
Addresses coordination among Medicare quality reporting and electronic reporting initiatives, including updates to incentive program alignment.
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DME face-to-face requirement
Summarizes documentation expectations tied to durable medical equipment prescribing and payment.
What You Will Learn
- How the final 2013 Medicare physician fee schedule changed payment expectations.
- What broad policy areas were updated in the rule.
- Which provider groups and reporting programs were affected.
- How Medicare linked fee schedule changes with quality and documentation requirements.
Who Should Read This
- Physicians
- Primary care practices
- Medical coders
- Billing and reimbursement professionals
- Compliance staff
- Practice administrators
- Non-physician practitioners
Codes Discussed
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