decisionhealth Newsletters, Part B News - 2011 Issue 7 (July)
Proposed 2012 fee schedule targets imaging payments, optimizes EHR and PQRS
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Article Overview
This article summarizes major elements of the proposed 2012 Medicare Physician Fee Schedule and explains why the rule matters to physicians, group practices, and organizations that track Medicare reimbursement and quality-reporting policy. It covers broad changes affecting imaging payment methodology, conversion factor updates, annual wellness visit policy, electronic health record incentive reporting, PQRS participation, geographic practice cost adjustments, telehealth additions, and the planned value-based payment modifier. The piece is useful for coding, compliance, reimbursement, and practice management readers who need a high-level view of CMS policy direction before the final rule.
Why This Topic Matters
The proposal signals changes that can affect Medicare payment levels, reporting workflows, and future performance-based reimbursement for many physician specialties and group practices.
Article Sections
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Advanced imaging cut
Summarizes proposed Medicare payment policy changes related to advanced diagnostic imaging and interpretation services.
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Conversion factor
Addresses the proposed update to the Medicare physician conversion factor and related fee schedule context.
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Annual wellness visit updates
Describes proposed changes affecting annual wellness visit requirements and related preventive care processes.
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Meaningful use
Covers proposed changes to electronic health record-based reporting for clinical quality measures in the incentive program.
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PQRS and EHRs
Discusses proposed integration of EHR systems with quality reporting under the Physician Quality Reporting System.
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PQRS group reporting
Reviews proposed simplification of group practice reporting and measure updates within PQRS.
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GPCI revisions
Summarizes proposed changes to geographic practice cost indices and the data sources supporting them.
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Telehealth changes
Covers proposed updates to the telehealth service list and criteria for adding services.
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New value modifier
Introduces the planned value-based payment modifier and the general cost-and-quality factors involved.
What You Will Learn
- Which major Medicare payment and reporting areas are affected by the proposed rule
- How the proposal may influence imaging reimbursement, quality reporting, and telehealth coverage
- What broad policy changes CMS is considering for physician practices and group reporting
- How the proposed rule fits into the transition toward value-based payment
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Revenue cycle teams
- Quality reporting staff
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