CMS Releases Proposed 2010 Medicare Physician Fee Schedule Update
07/13/2009The proposed 2010 Medicare physician fee schedule update (Proposed 2010 MPFS), published in the Federal Register on July 13, 2009, includes several important new proposals, some of which are noted here.
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The most notable proposal is the elimination of reimbursement for the higher-paying consultation codes currently used by specialists. CMS proposes using the savings to pay higher reimbursement for the office visits performed by primary care physicians. Specialists would have to start billing for consultations under the same office visit codes used by primary care physicians.
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Under current Medicare law, CMS must adjust MPFS payment rates based on the Sustainable Growth Rate and other factors. The proposed rule projects a 21.5 percent rate reduction as a result of the Sustainable Growth Rate for calendar year 2010. However, most observers expect Congress to prevent such an outcome through legislative action as it has done for calendar years 2004 through 2009.
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CMS proposes a rule change to clarify a point of interpretation of the Stark regulations’ “stand in the shoes” provision.
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The Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) created new benefit categories for intensive cardiac rehabilitation, pulmonary rehabilitation and chronic kidney disease education, effective 2010. The Proposed 2010 MPFS includes regulatory conditions of coverage for these new Medicare benefit categories.
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Implementing a provision of MIPPA, CMS proposes a new accrediting process for technical component suppliers of MRI, CT, nuclear medicine and PET, including physician offices. Such suppliers must be accredited by an approved accrediting organization by January 1, 2012.
Comments on the proposed rule are due August 31, 2009.
