tci Part B Insider - 2009 Issue 3

Part B Payment: Calculate Fees Differently in '09

We'll show you how your payer will establish fees. CMS has tried to make it easier for you to calculate fees this year -- but for some practices, one step forward results in two steps back. The lowdown: CMS recently condensed all 56 Physician Fee Schedule (PFS) carrier specific pricing files into one zip file (available online at www.cms.hhs.gov/PhysicianFeeSched/PFSCSF/list.asp). However, many physicians are confused about how CMS has derived its calculations this year. Although the 2009 conversion factor slipped from 38.0870 to 36.0666, in 2009, CMS no longer applies a budget neutrality adjuster...

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