tci Medicare Compliance & Reimbursement - 2012 Issue 14
Part B Payment: Take A Sneak Peek At The Proposed 2013 Fee Schedule
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Article Overview
This article reviews CMS’s proposed 2013 Medicare Physician Fee Schedule and summarizes the broad payment changes under consideration. It covers the policy areas most relevant to physician billing, including payment adjustments tied to care coordination after facility discharge, multiple procedure payment reductions for certain diagnostic services, the projected impact of the sustainable growth rate formula, and specialty-specific payment changes affecting several physician groups. The piece is useful for practices, coders, and revenue cycle staff who want a high-level preview of proposed Medicare payment policy before final rulemaking.
Why This Topic Matters
The proposed fee schedule can significantly affect Medicare reimbursement, practice planning, and coding-related workflow for multiple specialties. Understanding the scope of the proposal helps stakeholders evaluate possible financial and operational changes before the rule is finalized.
Article Sections
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Basics
Introduces the proposed Medicare Physician Fee Schedule for 2013 and frames the article’s focus on broad payment policy changes and specialty impacts.
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Proposal Would Pay for Hospital Transitions
Summarizes proposed Medicare payment policy related to care coordination after discharge from a hospital or skilled nursing facility.
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Multiple Procedure Cuts Could Hurt Cardiologists, Ophthalmologists
Covers the proposed multiple procedure payment reduction policy affecting selected diagnostic services and the physician groups most likely to be affected.
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More Steep Cuts Will Hit
Discusses the projected overall Medicare physician payment reduction and the broader budgetary context described in the proposal.
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Further cuts for some specialties:
Highlights proposed reimbursement changes affecting radiation oncology and related therapy services, including broader specialty payment effects.
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Primary care bonus:
Summarizes proposed payment increases for primary care and selected other specialties under the 2013 fee schedule proposal.
What You Will Learn
- What areas of the proposed Medicare Physician Fee Schedule are highlighted in the article
- Which specialties are described as facing proposed payment increases or decreases
- What kinds of Medicare payment policy changes are being previewed for 2013
- How the article frames the potential operational relevance of the proposal for physician practices
Who Should Read This
- Physician practices
- Medical coders
- Revenue cycle staff
- Billing managers
- Healthcare administrators
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