Proposed 2008 fee schedule: 10% cut proposed as expected, but smaller cuts likely to add up

Why This Topic Matters

The proposed rule can affect reimbursement across many specialties, not just through the overall conversion-factor change but also through revisions to work, practice expense, geographic, telehealth, and other payment elements. Understanding the scope of the proposal helps practices assess financial exposure, prepare comments, and anticipate downstream billing and payment impacts.

Article Sections

1. Overview of the proposed 2008 fee schedule

   Introduces the CMS proposal and summarizes the major Medicare Physician Fee Schedule changes discussed in the article. It frames the payment-policy issues that may affect a wide range of specialties.

2. Payment formula components and budget neutrality

   Explains the major elements used to calculate physician payment and describes the broader budget-neutrality context. It discusses how changes to work, practice expense, and geographic adjustments can affect reimbursement.

3. Practice expense, RUC actions, and specialty impacts

   Covers proposed changes affecting practice expense methodology and selected work relative value unit updates. It notes that the article reviews implications for several specialty areas and service categories.

4. Quality reporting, self-referral, and related policy proposals

   Summarizes other CMS policy topics addressed in the proposed rule, including quality reporting and physician self-referral-related issues. It highlights that the article also touches on reassignment, anti-markup, and joint venture proposals.

5. Highlighted fee schedule topics by specialty or service area

   Reviews selected subject areas such as telehealth, radiology, ophthalmology, Mohs surgery, cardiac rehabilitation, IVIG, e-prescribing, laboratory tests, and physician-administered drugs. The section is a broad survey of policy changes affecting specific services.

6. Tables of proposed payment changes for commonly billed services

   Presents tabular summaries of selected CPT/HCPCS services and their proposed payment changes for 2008. The article uses these examples to illustrate the effect of the proposed fee schedule on commonly billed services.

7. Work RVU changes carried over from the five-year review

   Includes a second table of services affected by proposed work RVU changes from prior review activity. It shows another set of example codes and payment changes discussed in the article.