Physician Fee Schedule

News & Analysis as of

Want To Complain About The 2015 Medicare Physician Fee Schedule? Take A Number.

Apparently Americans feel that way about Medicare’s traditional fee-for-service physician compensation schedule. Everybody complains about it, but nobody likes any proposed changes. That’s clear from the reaction to the...more

CMS Releases Proposed 2015 Physician Fee Schedule and Pojects 20.9% SGR Reduction

CMS has issued the Proposed 2015 Physician Fee Schedule and Fact Sheets for specific issues (ASC, ESRD, Home Health, Physician Quality Programs)....more

CMS Releases Proposed 2015 Physician Fee Schedule and Outpatient Prospective Payment System Rules

On July 3, 2014, the Centers for Medicare and Medicaid Services (“CMS”) released its proposed Calendar Year (“CY”) 2015 Physician Fee Schedule (“PFS”) Proposed Rule, to be published in the Federal Register on July 11, 2014....more

Medicare Fee Schedule and Florida PIP Coverage

In the state of Florida and other states that use no-fault auto insurance systems, specific issues involving insurance payouts are often part of traffic accident personal injury claims. Florida personal injury lawyers need to...more

President Signs Medicare Physician Fee Schedule/SGR Patch with Numerous Health Policy Provisions

In This Issue: - One-Year Medicare Physician Fee Schedule Fix - Valuation of Services Under the Physician Fee Schedule - ICD-10 Delay; LTCH Moratorium to Become Effective Immediately - Skilled Nursing...more

Medicare Physician Fee Schedule Expands Telehealth Coverage in 2014

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for Medicare’s Physician Fee Schedule for 2014 Calendar Year (“CY). While physicians are expected to see a 20.1% reduction to their...more

Health Reform + Related Health Policy News - December 2013

In This Issue: - Top News ..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health ..President Signs the Drug Quality...more

CMS Announces Plans to Modernize and Update the Clinical Laboratory Fee Schedule

On November 27, 2013, Centers for Medicare & Medicaid Services posted the final 2014 Medicare physician fee schedule and, in it, announced plans to change how and how much Medicare pays for clinical diagnostic laboratory...more

Health Care Fraud and Abuse Alert: What CMS’s New Billing Requirement For “Incident To” Services Means For Medicare Providers.

In the final Medicare Physician Fee Schedule for 2014 (“2014 PFS”), CMS implemented a new condition of payment for “incident to” services that has significant fraud and abuse implications for any Medicare provider who relies...more

CMS Releases Final Rule for 2014 Medicare Physician Fee Schedule

CMS has released its much-anticipated final rule with comment for the Calendar Year (CY) 2014 Medicare Physician Fee Schedule (PFS). The final rule prescribes physician payment rates that will go into effect on January 1,...more

CMS Issues Medicare Physician Fee Schedule Final Rule

On November 27, 2013, CMS released a 1,369 page display copy of the CY 2014 Medicare Physician Fee Schedule (PFS) final rule. The final rule, which was delayed because of the government shut-down in October, is scheduled to...more

CMS Issues Medicare Physician Fee Schedule Without Finalizing Proposal Most Harmful to Independent Laboratories

On the day before Thanksgiving and a little over one month after the end of the government shutdown, the Centers for Medicare & Medicaid Services (“CMS”) published a rule finalizing revisions to payment policies under the...more

2014 Medicare Physician Fee Schedule Final Rule Under Review

The White House Office of Management and Budget (OMB) received the 2014 Medicare Physician Fee Schedule Final Rule (Physician Fee Schedule) for review on November 21, 2013. OMB is responsible for reviewing agency rules prior...more

CMS Announces Delay in Issuance of Final Rules

On October 23, 2013, CMS issued a memorandum to providers announcing that the publication of several final rules would be delayed, possibly until the end of November. The memorandum noted that the rules, though published...more

SGR Reform—Improved Outlook for Congressional Action This Year?

What is the SGR? The Sustainable Growth Rate (SGR) formula was enacted in 1992 as a statutory means of controlling Medicare spending by calculating annual updates to the Medicare physician fee schedule. The fee...more

CMS Issues Proposed Rule That Will Update Payment Policies/Rates Under the Medicare Physician Fee Schedule

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that will update payment policies and rates under the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2014 on July 6, 2013....more

2014 Physician Fee Schedule: Cuts and Quality and Data! Oh My!

The Centers for Medicare and Medicaid Services (CMS) recently released the calendar year 2014 Physician Fee Schedule Proposed Rule (Proposed Rule)....more

CMS Issues Proposed CY 2014 Medicare Physician Fee Schedule (MPFS) Rule and Suggests New Standars for Reimbursement of...

On July 19, 2013, CMS issued the proposed CY 2014 MPFS rule and suggested significant modifications to its regulations governing Medicare coverage of investigational devices and the routine items and services furnished to...more

CMS Proposes New Standards and Processes for Medicare Coverage of Investigational Devices and Related Clinical Studies and Trials

In its proposed update to the Physician Fee Schedule for calendar year 2014, the Centers for Medicare & Medicaid Services (CMS) suggested major revisions to its regulations governing Medicare coverage of investigational...more

CMS Proposes 2014 Medicare Physician Fee Schedule; SGR Reduction Projected @ 24.4%

CMS has issued the poroposed Medicare Physician Fee Schedule. Without Comf=gressional intervention, the SGR will mandate a 24>4% decrease. CMS sent its calcuations to the Medare Payment Advisory Commission....more

CR7631: Changes to Place of Service Coding Effective April 1, 2013

After the OIG identified a high error rate for Place of Service (“POS”) modifiers over several years, the Centers for Medicare and Medicaid (“CMS”) issued a billing and coding revision (CR 7631) to instruct any physician,...more

CMS to Apply the Multiple Procedure Payment Reduction on the Professional Component and Technical Component of Certain Diagnostic...

Beginning January 1, 2013, physicians in the same practice group who provide certain diagnostic imaging services may be required to bill at reduced rates, due to a broadened application of the Multiple Procedure Payment...more

SGR Cuts of Over 26% to Take Effect on January 1, 2013

On December 19, 2012, CMS issued a notice advising physicians of impending payment cuts to the Medicare Physician Fee Schedule. For calendar year 2013, the sustainable growth rate formula (SGR) calls for a 26.5% cut in...more

New Medicare Regulations Require Face-to-Face Physician Encounters for DME Products

On November 16, 2012, the Centers for Medicare & Medicaid Services ("CMS") published a final rule making various changes to payment policies under the Physician Fee Schedule. Included in this rule is a new requirement that...more

CMS Releases its CY 2013 Physician Fee Schedule Final Rule

CMS has released its Calendar Year (CY) 2013 Final 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...more

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