Getting paid: Medicare could chop orthopedists’ pay for hip and knee replacement in 2014

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers a proposed Medicare payment change affecting orthopedic joint replacement services, including the role of CMS, the AMA’s RUC, and professional society concerns about how the policy could be implemented. It is written for orthopedic coders, practice managers, and physicians tracking Medicare physician fee schedule developments and the possible effects on reimbursement, patient access, and other payer fee schedules.

Why This Topic Matters

Readers need to understand how Medicare physician fee schedule changes can affect orthopedic practice revenue, payer contracts that reference Medicare values, and decisions about service mix and Medicare patient volume.

What You Will Learn

  • How Medicare physician fee schedule changes can affect orthopedic reimbursement
  • How CMS and specialty organizations can differ on relative value recommendations
  • Why payment policy changes may influence practice mix and payer contracting
  • What kinds of stakeholders monitor proposed and interim final rulemaking

Who Should Read This

  • Orthopedic surgeons
  • Medical coders
  • Practice managers
  • Billing staff
  • Healthcare administrators

Codes Discussed


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