tci Medicare Compliance & Reimbursement - 2012 Issue 19
News You Can Use: Pathologists And Labs: Brace for More Pay Cuts in 2013
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Article Overview
This article discusses proposed Medicare Physician Fee Schedule and Clinical Laboratory Fee Schedule payment changes for 2013, with attention to how the updates may affect pathologists, non-primary care physicians, and clinical labs. It is useful for pathology, laboratory, and physician billing professionals who need a high-level view of federal payment policy developments, including the role of CMS proposals, the SGR methodology, the primary care initiative, and current-law fee schedule updates.
Why This Topic Matters
Payment updates and federal policy changes can directly affect reimbursement expectations for pathology and lab services. The article helps readers understand the broad direction of proposed cuts and the legislative or regulatory factors that could alter final payment outcomes.
Article Sections
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Medicare payment outlook for 2013
Introduces the proposed Medicare payment environment for the coming year and the policy context behind the expected changes. It frames the article around CMS proposals and broader federal payment updates.
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Pathologists lose to primary care physicians
Summarizes the article’s discussion of how primary care payment initiatives may affect other physician specialties. It focuses on pathology as one of the affected areas within the physician fee schedule.
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Expect lab cuts too
Reviews the article’s coverage of projected laboratory payment changes under the clinical laboratory fee schedule. It also addresses the general mix of statutory and formula-driven factors behind the anticipated update.
What You Will Learn
- The broad Medicare policy forces that may affect pathology reimbursement in 2013.
- How proposed physician fee schedule changes relate to primary care and non-primary care specialties.
- Why clinical laboratory payment updates are being discussed in the context of federal fee schedule formulas and current law.
- The role of CMS and Congress in determining whether proposed reductions take effect.
Who Should Read This
- Pathologists
- Clinical laboratory administrators
- Medical billing and coding professionals
- Revenue cycle staff
- Healthcare reimbursement analysts
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