Outpatient Facility Coding Alert - 2006 Issue 12
PHYSICAN FEE SCHEDULE UPDATE ~ Find Out Why Your ED E/Ms Will Be Worth More in 2007
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Article Overview
This article reviews Medicare’s 2007 physician fee schedule changes as they relate to emergency medicine. It focuses on emergency department evaluation and management services, critical care reimbursement, conversion factor changes, and the broader payment context for hospital-based specialties. The piece is aimed at emergency physicians, coders, and reimbursement professionals who need to understand how annual fee schedule updates may affect claims, documentation review, and practice revenue.
Why This Topic Matters
Fee schedule updates can change relative payment levels across commonly billed emergency department services and affect revenue expectations for the year. Understanding the scope of the Medicare changes helps coding and billing teams evaluate documentation, reimbursement trends, and the financial impact on emergency medicine practices.
Article Sections
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CMS updates to the 2007 physician fee schedule
Introduces the Medicare fee schedule update and frames the payment changes affecting emergency medicine and other specialties.
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Emergency department E/M RVU changes
Summarizes the revised work value adjustments for emergency department evaluation and management services and the overall direction of those changes.
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Documentation and coding considerations
Discusses the importance of supporting the assigned service level with documentation and highlights the need for accurate code selection in emergency department claims.
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Critical care RVU updates
Covers the fee schedule updates affecting critical care reimbursement and places them alongside the ED E/M changes.
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Conversion factor and budget neutrality effects
Explains how Medicare’s conversion factor and related budget adjustments influence the net effect of the fee schedule update.
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Overall revenue outlook for emergency medicine
Provides the article’s broader discussion of expected reimbursement trends for emergency departments compared with other specialties.
What You Will Learn
- How the 2007 Medicare physician fee schedule affects emergency medicine reimbursement
- What parts of the fee schedule changed for emergency department evaluation and management services
- Why critical care payment updates are included in the discussion
- How broader Medicare pricing adjustments can influence net reimbursement
- What operational factors can affect the financial impact of a fee schedule update
Who Should Read This
- Emergency physicians
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice administrators
Codes Discussed
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