2009 Physician Fee Schedule

Posted on December 5, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

CMS Issues Final Rule

Staff Reporters

coinsAccording to the American Medical News on November 24, legislation enacted in July reversed a 10.6 percent cut that took effect at the beginning of that month, while starting in January 2009, a 1.1 percent across-the-board increase will replace an additional roughly 5 percent cut that would have gone into effect if lawmakers had not acted.

Bonus Opportunities

Because the rule applies payment changes related to the most recent five-year adjustment in Medicare relative values for certain services, some physician specialties might see updates slightly larger than or smaller than 1.1 percent. But, CMS stressed that two bonus opportunities exist to more than quadruple the raise that doctors will get for the year.

Example:

For example, physicians who successfully participate in the Physician Quality Reporting Initiative [PQRI] will receive a 2 percent bonus on all of their Medicare payments for the year, while the program for the first time will award a separate 2 percent bonus to physicians who successfully prescribe medications electronically for their Medicare patients.

Assessment

Although the sums will not be paid out until sometime in 2010, after Medicare has processed all of next year’s claims, this means the maximum effective raise for 2009 will be 5.1 percent.

Conclusion

What do you think about this fee increase? Your thoughts and comments on this Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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2 Responses

  1. Executive-Post, on November 26, 2008 at 1:14 AM said:

    Shared Savings Program

    CMS delayed finalizing an exception for shared savings programs in the 2009 Medicare Physician Fee Schedule Final Rule issued on Oct. 30, 2008, because CMS believed it had received too few comments to craft an appropriate exception for shared savings programs that would not risk fraud to the Medicare program. CMS will accept additional comments on ways to appropriately structure such an exception until mid-February 2009.

    -Stewart

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  2. Ann Miller RN MHA, on April 12, 2011 at 10:35 AM said:

    Bill Seeks Outside Review of Relative Values in Medicare Services

    Rep. Jim McDermott, MD (D-WA) introduced the Medicare Physician Payment Transparency and Assessment Act of 2011 on March 30th.

    The bill explicitly would require independent contractors to identify misvalued physician services on an annual basis and recommend adjustments. The national health system reform law already states that the Health and Human Services secretary “may use analytic contractors,” but the new measure would make this mandatory.

    Since 1992, a panel convened by the American Medical Association and representing a wide range of specialties has recommended thousands of pay changes to the individual services doctors provide to Medicare patients. The bill would add a layer of review on top of the 29-member AMA/Specialty Society Relative Value Scale Update Committee, known as the RUC.

    Source: Charles Fiegl, AMNews [4/11/11]

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