Tn Family MD said:
Wow, Kent, I didn't think it was by that much. I can't recall where the article was that I read, but it said about 5% increase for PC Specialties and 6-7% decrease for rads and anesthesia specifically and less of a decrease for other things such as cards, ortho and other specialties.
The 12-15%* estimate is extrapolated based on typical family medicine coding, where the majority of visits are 99213/99214. I don't have a link for that figure, as it was part of a presentation at a conference I went to recently.
There's little doubt that the money is going to come from procedures, as they're also revising the way they're paying for procedural work.
Don't forget that since most commercial insurance plans peg their fees to Medicare, there will be a ripple effect outside of Medicare, as well.
👍
Here's something I found online:
Medicare law requires CMS to assess the accuracy of the relative values it assigns to physician services every five years. CMS last changed the work RVUs assigned to the E/M services in 1997. In a proposed rule, to be published in the Federal Register on June 29, 2006, CMS proposes increases be implemented January 1, 2007.
The increases in work RVUs proposed by CMS, based on the Relative-value scale Update Committee's (RUC) recommendations, would include increases for some of the E&M codes most commonly billed:
* The work RVU for a mid-level established patient office visit, 99213,
would increase by 37%.
* The work RVU for the highest-level initial hospital visit, 99223,
would increase by 26%.
* The work RVU for the mid-level subsequent hospital visit, 99233,
would increase by 31%.
By law, CMS must offset the total increases in work RVUs from the five year review with a separate adjustment so that 2007 expenditures are roughly equal to their 2006 level. Even after the budget neutrality adjustment is applied, 2007 Medicare payments for many E/M services would increase significantly, assuming continuation of the current 2006 conversion factor. For example:
* For CPT code 99213 the 2006 fee is $52.68, the 2007 fee would be $59.42.
This is a 12.8% change.
* For CPT code 99223 the 2006 fee is $157.29, the 2007 fee would be $173.27.
This is a 10.2% change.
* For CPT codes 99233 the 2206 fee is $79.21, the 2007 fee would be $90.95.
This is a 14.8% change.
Here is another document that includes a summary of the effects of the proposed changes on each medical specialty (it's a PDF file...look at the table at the very bottom of the document):
http://www.hospitalmedicine.org/AM/...mplate=/CM/ContentDisplay.cfm&ContentID=10204
When the changes are fully implemented in 2010, the biggest losers will be Clinical Psychology (-15%), Clinical Social Work (-14%), Chiropractic (-11%), Anesthesiology (-10%), Nurse Anesthesia (-10%), Interventional Radiology (-8%), Nuclear Medicine (-7%), Pathology (-7%), and Ophthalmology (-6%).
I'm not sure why the mental health fields took such a hit. Even Psychiatry, an almost purely cognitive specialty, is -1%. That doesn't seem right, given the already abysmal state of mental health services in this country.
Family medicine isn't the only cognitive field that gets a positive bump. Several internal medicine specialties receive comparable increases. In particular, Infectious Disease is listed as +10%, and Dermatology is +7%. Interestingly, reimbursements to Independent Laboratories also increase by 19%, which should help physicians who have invested in diagnostic labs.
*
I just checked my notes, and it's 12-15%, not 15-17% as I typed earlier. My bad.
