A look ahead: The physician payment formula won't be fixed; drug prices will continue to fall in 2005. Those are among sev-eral Part B News predictions for the year ahead

Why This Topic Matters

The article helps readers anticipate changes that could affect Medicare reimbursement, claims timing, coding review activity, drug billing operations, and appeals workflow during the year ahead.

Article Sections

1. Medicare physician payment update outlook

   Discusses expectations for the Medicare physician fee update and broader budget pressures affecting payment policy in 2005.

2. E/M guideline and clinical example proposals

   Covers AMA and CMS activity related to evaluation and management coding guidance and proposed clinical example testing.

3. CMS review of potentially overvalued codes

   Summarizes CMS plans to send selected service codes for external review through the physician valuation process.

4. Drug reimbursement and office-administered drugs

   Addresses expectations for Part B drug payment trends and the effect on practices that bill Medicare for administered drugs.

5. Newly implemented G codes and claims processing

   Discusses anticipated claim-processing delays tied to newly introduced Medicare billing codes and implementation timing.

6. Carrier education and claims error initiatives

   Covers Medicare carrier education efforts and the relationship between payment error measurement and administrative funding.

7. Medicare Part B appeals transfer

   Reviews the planned transfer of Part B appeals responsibilities and expected operational effects on the adjudication process.