Part B Insider - 2009 Issue 11
Calculate How the Fee Schedule Changes Affect Your Pay
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Article Overview
This article explains the potential reimbursement effects of CMS’s proposed 2010 physician fee schedule changes. It discusses broad evaluation and management payment shifts, the proposed removal of consultation code payment, and the likely financial and compliance implications for different practice settings and specialties. The piece is aimed at coders, billers, compliance staff, and physicians who need to understand how the proposal could alter payment patterns and reporting practices.
Why This Topic Matters
The article addresses a major proposed Medicare payment change that could affect physician revenue, coding workflows, and audit/compliance exposure across outpatient and inpatient settings.
Article Sections
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Double-Digit Rate Cut Is a Factor, Too
Discusses proposed fee schedule payment changes affecting evaluation and management services and the broader reimbursement environment. It also frames the expected financial impact across office, hospital, and nursing facility settings.
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Do the Math to Figure the Effect
Reviews the anticipated financial effects of the proposal on different categories of physician services. The section also contrasts outpatient and inpatient impacts and highlights practice-level differences by specialty.
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Specialty Pay Will Likely Take a Hit
Explores how the proposal may affect specialty practices compared with primary care. It also addresses the compliance and operational considerations that may arise from the change.
What You Will Learn
- The general scope of CMS’s proposed fee schedule changes
- How evaluation and management reimbursement may be affected
- Why the proposal may have different effects on primary care and specialty practices
- What operational and compliance issues the change may raise
- How the proposal relates to physician payment in office and hospital settings
Who Should Read This
- Medical coders
- Physician billers
- Compliance staff
- Physicians
- Practice managers
- Healthcare consultants
Codes Discussed
Code Ranges Discussed
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