SPECIAL REPORT: CMS warns of looming payment cuts in 2009 Medicare Physician Fee Schedule

Why This Topic Matters

The rule touches multiple parts of Medicare reimbursement and administration, so practices need to know what changed for payment, coverage, reporting, and billing workflows. It also highlights several code-set updates and CMS program changes that may affect claim preparation and operational planning.

Article Sections

1. Fee schedule overview and payment updates

   Summarizes the overall Medicare physician fee schedule update and related payment context for 2009. Includes discussion of conversion factors and broad fee schedule impacts.

2. Stark referrals and preventive services

   Covers CMS changes involving referral-related lists and the agency’s approach to preventive services. Also references how future preventive services will be identified and added.

3. Welcome to Medicare changes

   Describes updates affecting the initial preventive visit and related service requirements. Addresses associated reporting, timing, and valuation topics.

4. Screening EKGs and related billing

   Explains changes tied to EKG-related services in connection with Medicare preventive visits and referrals. Also notes related valuation comparisons.

5. PQRI, e-prescribing, and audiologists

   Summarizes quality reporting and electronic prescribing program updates. Includes changes affecting participation options and provider categories.

6. Physician feedback reports and GPCI floor

   Reviews the new physician resource use feedback program and geographic payment adjustments. Also notes regional policy changes affecting Medicare payment calculations.

7. Therapy cap changes and speech-language pathology

   Covers therapy-related payment limits and enrollment or billing changes for speech-language pathology services. Includes related Medicare policy and self-referral topics.

8. Telehealth and bundling payments

   Describes telehealth site expansions and related payment limitations. Also addresses broader CMS efforts involving bundled payments and multiple procedure payment reduction issues.

9. RVU changes and non-covered services

   Summarizes valuation revisions and CMS decisions on selected services and code groups. Includes discussion of newly reviewed or maintained coverage positions.

10. Pelvic fractures and related G codes

    Covers code updates involving fracture-related services and CMS-created replacements. Notes the relationship between CMS G codes and existing CPT references.

11. E-prescribing fax exemption and shared savings proposals

    Reviews CMS actions on e-prescribing policy and certain self-referral or gainsharing proposals. Also mentions the public comment process for these topics.

12. Anti-markup revisions and additional telehealth codes

    Summarizes diagnostic test anti-markup revisions and added telehealth consultation coding. Includes discussion of service settings and related procedural groupings.

13. PECOS implementation

    Outlines the staged rollout of the internet-based enrollment system for providers and suppliers. Focuses on implementation phases across provider categories.

14. Additional CPT and HCPCS changes

    Covers selected code revisions, payment changes, and multiple procedure payment reduction additions. Includes diagnostic imaging, infusion, and cardiac-related updates.

15. HPSA modifier guidance and comments

    Addresses geographic shortage-area payment issues and CMS guidance for affected claims. Also includes the article’s closing note on comments and submission details.