decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 8 (August)
Proposed Physician Fee Schedule for 2011 contains 6% pay cut
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Article Overview
This article covers CMS’s 2011 proposed Physician Fee Schedule, including the overall payment update, comment timeline, and selected policy changes affecting physician reimbursement, practice expense calculations, quality reporting, imaging assumptions, and geographic practice cost indices. It is useful for physicians, practice managers, coders, and reimbursement professionals who need a high-level view of proposed Medicare payment changes and the types of services likely to be reviewed or adjusted.
Why This Topic Matters
The proposal could affect physician reimbursement, practice expense valuation, quality reporting participation, and payment assumptions for several service categories. Reviewing the article helps stakeholders understand which broad areas of billing and reimbursement are being targeted in the proposed rule.
Article Sections
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Proposed 2011 payment update and comment timeline
Overview of the proposed physician fee schedule, the expected payment impact, the conversion factor, and the public comment and final rule timeline.
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Services and codes targeted for RUC review
Discussion of the types of services CMS identified for review and examples of commonly cited procedures and diagnostic services included in that review process.
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Intercostal nerve service valuation changes
Summary of practice expense and malpractice valuation changes for intercostal nerve-related services, including the presented RVU comparison table.
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Other proposed policy changes
Additional proposed updates affecting quality reporting initiatives, group practice participation, advanced imaging assumptions, and geographic practice cost adjustments.
What You Will Learn
- How CMS’s proposed physician payment update is framed for 2011
- Which broad service categories were highlighted for review under the fee schedule
- What kinds of practice expense and malpractice adjustments were discussed
- Which quality reporting and imaging policy changes were proposed
- How geographic practice cost policy was addressed for certain states
Who Should Read This
- Physicians
- Medical practice administrators
- Professional coders
- Revenue cycle staff
- Health care reimbursement analysts
- Compliance staff
Codes Discussed
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