decisionhealth Newsletters, Answer Books - 2011 Issue 12 (December)
Medicare Fee Schedule / Fee Schedule 2012
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Article Overview
This article reviews key 2012 Medicare Physician Fee Schedule updates and their impact on physician reimbursement, imaging-related payment methodology, quality reporting measures, and selected administrative policy changes. It is aimed at coders, billing staff, compliance teams, and practice managers who need a broad understanding of annual Medicare payment rule changes and reporting requirements.
Why This Topic Matters
Annual fee schedule changes can affect payment rates, procedure valuations, reporting obligations, and operational workflows across multiple specialties. Understanding the scope of the 2012 updates helps practices prepare for reimbursement changes and related compliance adjustments.
Article Sections
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2012 Physician Fee Schedule overview
Introduces the overall payment environment for 2012 and summarizes several major Medicare policy changes affecting physician services.
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CMS finalizes proposed RVU adjustments
Discusses relative value unit changes for selected services and references the final fee schedule addenda where the updates are detailed.
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MPPR not as harsh for advanced imaging interpretation
Summarizes Medicare’s multiple procedure payment reduction approach for selected advanced imaging services and points to the relevant fee schedule addendum.
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CMS drops signed lab requisition requirement
Explains a policy reversal related to ordering documentation for clinical laboratory work and the reasons CMS gave for the change.
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Quality reporting in 2012
Covers selected quality reporting measures for the year, including reporting channels and general measure themes.
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3-day window for hospital-run practices
Describes a Medicare payment policy affecting services furnished by hospital-owned or operated practices and notes certain exclusions.
What You Will Learn
- How the 2012 Medicare Physician Fee Schedule changes affect payment and reporting
- Which broad service categories were affected by relative value unit updates
- How imaging-related Medicare payment policy was adjusted for 2012
- What changed for selected quality reporting measures and lab requisition policy
- How the hospital payment window rule affects certain practice settings
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Practice managers
- Physician practices
- Anesthesia and pain management providers
Codes Discussed
Code Ranges Discussed
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