decisionhealth Newsletters, Part B News - 2009 Issue 11 (November)
RVUs under new dataset will fall for imaging
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Article Overview
This article explains upcoming Medicare Physician Fee Schedule changes tied to the transition from one practice-expense data source to another, with emphasis on how the shift affects imaging-related services versus other high-volume office services. It is aimed at coders, billers, and practice leaders who need to understand broad fee schedule impacts, the phase-in timeline, and where to look in the 2010 final rule for additional affected services.
Why This Topic Matters
The article helps readers gauge whether their most commonly billed services may see payment changes under the updated Medicare fee schedule and broader PE-RVU methodology changes.
Article Sections
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Overview of the PE-RVU changes
Introduces the upcoming fee schedule adjustments and the general direction of payment impacts across specialties, with a focus on imaging-heavy services.
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Examples of service-level payment impact
Illustrates how selected high-volume services are affected under the transitional and fully implemented methodology over time.
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What to do about the changes now
Provides a general call to review commonly billed services and monitor the fee schedule resources for additional affected codes.
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Phase-in of the new dataset
Summarizes the multi-year transition schedule and the way the two datasets are blended during the phase-in period.
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CMS and AMA positions on supplemental data
Describes the organizations’ public positions on whether additional survey data should be incorporated during the transition.
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Snapshot of PPIS transition's greatest impacts on high-use codes
Introduces a chart-style summary of commonly billed services with notable changes over the transition period and the general categories most affected.
What You Will Learn
- How the Medicare fee schedule change is expected to affect practice-expense valuation.
- Which broad types of services are most likely to see payment pressure from the new dataset.
- How the transition period phases in the new methodology over multiple years.
- Where the article directs readers to look for additional affected services in the fee schedule.
- How CMS and AMA are framing the change and the use of supplemental survey data.
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician group administrators
- Specialty practices affected by Medicare fee schedule changes
Codes Discussed
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