Payment Matters: CMS Releases its CY 2013 Physician Fee Schedule Proposed Rule


CMS has released its Calendar Year (CY) 2013 Proposed Rule for practitioners who are paid under the Physician Fee Schedule (PFS). CMS anticipates that many non-primary care specialties will see a decrease in payments under the proposed rule. As a corollary, primary care physicians would see payment rates increase under the proposed rule.

CMS estimates that family care physicians would experience a 7 percent increase in payment rates, and other primary care physicians would see their payment rates increase 3-5 percent. The proposed rule may be viewed here. It is expected to be published in the July 30, 2012 Federal Register, with comments due no later than September 4, 2012. CMS anticipates that, without changes to current law, the Sustainable Growth Rate (SGR) adjustment to physician reimbursement will result in an approximate 27 percent cut in payment rates for 2013. This adjustment has historically been reversed through congressional intervention.

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Published In: Administrative Agency Updates, Health Updates, Insurance Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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