ObamaCare Targets Specialized Physicians and Surgeons

Med School Insiders
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teenmachinery1 said:
It only hurts if you don't get it. Refer to my previous post on the code changes.
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As far as I understand, it hurts even if you "get it." It could potentially be devastating to some practices. From what I've gathered, instead of billing for consultations, you bill as new patient or established patient. However, the new/established payment codes pay less RVUs than the consultation codes do, so you'll see a decrease in reimbursement. An example from The Happy Hospitalist (http://thehappyhospitalist.blogspot.com/2009/07/what-are-some-possible-unintended.html):

"I looked up the payment differences in my state for a 99245 outpatient consult vs a 99205 out patient new patient.

For the consult done in the office, it pays a little under 6 1/2 RVUs total,in dollar amount about $210.

For a new patient evaluation in the office, it pays about 5 RVUs total or about $170.

About a 20% cut.

I would say that constitutes a significant reduction in payment."

Edit: Feel free to correct me if my understanding is wrong.
 
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Kaushik said:
As far as I understand, it hurts even if you "get it." It could potentially be devastating to some practices. From what I've gathered, instead of billing for consultations, you bill as new patient or established patient. However, the new/established payment codes pay less RVUs than the consultation codes do, so you'll see a decrease in reimbursement. An example from The Happy Hospitalist (http://thehappyhospitalist.blogspot.com/2009/07/what-are-some-possible-unintended.html):

"I looked up the payment differences in my state for a 99245 outpatient consult vs a 99205 out patient new patient.

For the consult done in the office, it pays a little under 6 1/2 RVUs total,in dollar amount about $210.

For a new patient evaluation in the office, it pays about 5 RVUs total or about $170.

About a 20% cut.

I would say that constitutes a significant reduction in payment."

Edit: Feel free to correct me if my understanding is wrong.
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You site a hospitalist blogger who came up with an equation where they'll lose 40$ on their patient?

You could do better.

I can't find anything on the webs that says physicians will lose money using the new codes. These RVUs and medicare billing codes are sure fun to study though... (sike)
 
teenmachinery1 said:
You site a hospitalist blogger who came up with an equation where they'll lose 40$ on their patient?

You could do better.

I can't find anything on the webs that says physicians will lose money using the new codes. These RVUs and medicare billing codes are sure fun to study though... (sike)
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Well what did you expect him to find? The hospitalist did the work for him. (and it's not like he's just making blatant assumptions, he works it out for you) Is it really any different from an attending or resident who frequents SDN telling you otherwise?

As an aside, I'm not even sure if you can find those billing codes online, as there's no reason for the public to know about them any more than we are supposed to know the inventory of a walmart or the accounting sheets of some company. They aren't trying to hide it from us, but why publish it?
 
Kaushik said:
As far as I understand, it hurts even if you "get it." It could potentially be devastating to some practices. From what I've gathered, instead of billing for consultations, you bill as new patient or established patient. However, the new/established payment codes pay less RVUs than the consultation codes do, so you'll see a decrease in reimbursement. An example from The Happy Hospitalist (http://thehappyhospitalist.blogspot.com/2009/07/what-are-some-possible-unintended.html):

"I looked up the payment differences in my state for a 99245 outpatient consult vs a 99205 out patient new patient.

For the consult done in the office, it pays a little under 6 1/2 RVUs total,in dollar amount about $210.

For a new patient evaluation in the office, it pays about 5 RVUs total or about $170.

About a 20% cut.

I would say that constitutes a significant reduction in payment."

Edit: Feel free to correct me if my understanding is wrong.
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This was my point ... the AMA can lobby for better clarification or whatever else (represent 18% of physicians, debatable with respect to who they are concerned about, etc), but the medicare re-clarification of these codes still results in lower reimbursements.
 
You can enter in CPT codes and find out their payments here:

http://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp?

Here's a more credible site (AAN) for you teenmachinery:

http://www.aan.com/globals/axon/assets/6546.pdf

It shows the changes in the CPT codes and the changes in RVUs.

2009 Consult RVUs: Hosp / Ofc 2010 Visit RVUs: Hosp / Ofc

99241 0.92 / 1.35 99201 0.72 / 1.12
99242 1.94 / 2.52 99202 1.39 / 1.96
99243 2.70 / 3.46 99203 2.11 / 2.83
99244 4.27 / 5.11 99204 3.59 / 4.39
99245 5.33 / 6.28 99205 4.61 / 5.47

The table is from http://www.medac.com/index.php/news-a-events/billing-a-compliance-alerts/172-cms-eliminates-consults
 
Sorry to disrepute your hospitalist blogger source... but consider this one from the Centers for Medicare & Medicaid Services:

"
In the calendar year 2010 Medicare Physician Fee Schedule (MPFS) final rule with comment period (CMS-1413-FC), the Centers for Medicare & Medicaid Services (CMS) eliminated the use of all consultation codes (inpatient and office/outpatient codes) for various places of service except for telehealth consultation G-codes. The change will not increase or decrease Medicare payments. "

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf

http://www.healthcarefinancenews.com/blog/more-info-new-medicare-part-b-payment-codes

OWNED
 
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Also... funny that if the new codes will cost physicians to be compensated less from medicare, that the AMA's letter of opposition to the changing codes NEGLECTED TO MENTION ANYTHING OF THIS SORT.

Again, hate to rain on the blogger's parade, but read the letter from the AMA to Sebelius about their opposition to the changing codes and tell me where it says that the new codes will reimburse them less than before.

Have at it: http://www.ama-assn.org/ama1/pub/upload/mm/399/medicare-consultation-delay-letter.pdf
 
teenmachinery1 said:
Sorry to disrepute your hospitalist blogger source... but consider this one from the Centers for Medicare & Medicaid Services:

"
In the calendar year 2010 Medicare Physician Fee Schedule (MPFS) final rule with comment period (CMS-1413-FC), the Centers for Medicare & Medicaid Services (CMS) eliminated the use of all consultation codes (inpatient and office/outpatient codes) for various places of service except for telehealth consultation G-codes. The change will not increase or decrease Medicare payments. "

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf

http://www.healthcarefinancenews.com/blog/more-info-new-medicare-part-b-payment-codes

OWNED
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While Medicare has increased the RVUs of some codes (99201-99205), they are still lower than the previous year's consult codes (99241-99245), which you can see in the table I provided in my previous post. This means less revenue generated.

teenmachinery, you can also plug in the CPT codes in the link I provided in a previous post to find out what the payment for that code is.
 
Also, while I'm dispelling childish myths I might as well take a whack at this one...

There will NOT be 21% across-the-board cuts to physicians from medicare. This comes from some whacky formula that hasn't been taken seriously since 2001.

In other words, every year congress has thrown these whacky figures out and they'll do it again come march. This to me is not worth stressing about.

Unless you're thick.
 
Kaushik said:
While Medicare has increased the RVUs of some codes (99201-99205), they are still lower than the previous year's consult codes (99241-99245), which you can see in the table I provided in my previous post. This means less revenue generated.

teenmachinery, you can also plug in the CPT codes in the link I provided in a previous post to find out what the payment for that code is.
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Where in the letter from the AMA to the Health secretary about their opposition to these code changes did they mention these RVU codes?
 
teenmachinery1 said:
Where in the letter from the AMA to the Health secretary about their opposition to these code changes did they mention these RVU codes?
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Why does it matter if it was listed on AMAs letter or not? In addition to that, one can also question whether the AMA works to protect physician interests or not.

I have provided you with the changes to the CPT codes, sites where you can find the payments for CPT codes, assessment by the American Academy of Neurology (AAN), etc. which show that there's a general decrease in RVUs. If you don't understand how RVUs work, I'm sure a simple google search would clear that up for you, but the general idea is less RVUs = lower payments. A physician who does a lot of consultations (ex. neurology) may see a net decrease in reimbursement.
 
teenmachinery1 said:
Also, while I'm dispelling childish myths I might as well take a whack at this one...

There will NOT be 21% across-the-board cuts to physicians from medicare. This comes from some whacky formula that hasn't been taken seriously since 2001.

In other words, every year congress has thrown these whacky figures out and they'll do it again come march. This to me is not worth stressing about.

Unless you're thick.
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Yeah, I've heard this too and, based on past action, tend to agree.
 
Kaushik said:
Why does it matter if it was listed on AMAs letter or not? In addition to that, one can also question whether the AMA works to protect physician interests or not.

I have provided you with the changes to the CPT codes, sites where you can find the payments for CPT codes, assessment by the American Academy of Neurology (AAN), etc. which show that there's a general decrease in RVUs. If you don't understand how RVUs work, I'm sure a simple google search would clear that up for you, but the general idea is less RVUs = lower payments. A physician who does a lot of consultations (ex. neurology) may see a net decrease in reimbursement.
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Nope. http://www.aan.com/globals/axon/assets/6546.pdf is not an assessment from the AAN. Sorry.

I guess the Centers for Medicare and Medicaid services is just lying then. Refer to my quote from them and their link above.

Is this it? This and the hospitalist blogger is the only shred of evidence you can come up with to say that physicians will be reimbursed less with the new codes?

The AMA missed it? The ASA missed it? NYTIMES, Reuters, CNN, MSNBC, Glenn Beck, they're all colluding to keep this a secret from us?

Believe that too, then.
 
Mace1370 said:
You complain that physicians are acting entitled, yet you state that people everywhere are entitled to health care.

And yes, it is slavery when you argue that physicians should work for less than what their skills can demand in a free market.

Health care is not a right. Get over yourself.
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Health care should be a right buddy...and you want to be a doctor?

The only problem is that it's a right we can't afford :laugh:

I loathe the Republicans...I've lost faith in the Democrats...ugh...Life sucks when you're an Indie man.
 
Just because the AMA didn't mention it in their letter doesn't mean they missed it or that it doesn't exist. Same with the ASA, etc. I don't see why you're holding on to that AMA thing so much. You ought to know by now that the AMA isn't very representative of physicians and it has tended to act counter to what physicians want.

teen, since you seem to put a lot of faith on letters sent to CMS by medical societies, here's the AAN response to CMS: http://www.aan.com/globals/axon/assets/6322.pdf

"As a specialty that is already struggling with the low reimbursement for time spent evaluating and managing
patients, neurology would be keenly impacted by a coding change that would create additional
disincentives to spending the necessary time to talk to patients, take a thorough history, and provide
patient-centered care. Even though other E/ M codes would be increased, they would still be less than
current reimbursement for consultation services. The net impact on this would be negative for most​
neurologists."

Seems like that supports what I've been saying.
 
Kaushik said:
Why does it matter if it was listed on AMAs letter or not?
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The AMA goes, point by point, why they oppose the new consultation codes.

They did NOT mention lower medicare reimbursement.

Possibilities:
1. They forgot
2. They didn't look into it

Oops. Strange thing to leave out, I guess.
 
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If we're arguing about what CMS is going to do, Why don't you READ what they say they're going to do?

"
In the calendar year 2010 Medicare Physician Fee Schedule (MPFS) final rule with comment period (CMS-1413-FC), the Centers for Medicare & Medicaid Services (CMS) eliminated the use of all consultation codes (inpatient and office/outpatient codes) for various places of service except for telehealth consultation G-codes. The change will not increase or decrease Medicare payments. "

http://www.cms.hhs.gov/MLNMattersArt...ads/MM6740.pdf

http://www.healthcarefinancenews.com...-payment-codes

In the AMA's letter of opposition to the change in codes to the Secretary, they go through, point by point, their reasons for opposing the code in changes. http://www.ama-assn.org/ama1/pub/upload/mm/399/medicare-consultation-delay-letter.pdf Decreased compensation is NOT stated as a reason. Nothing like that is stated as a reason.

Read the CMS pdf. Read the AMA letter.
 
teenmachinery1 said:
First thought: WSJ... hmmm, okay fine. Let's see who wrote it.

Second thought: Scott Gottlieb = Resident Fellow @ the Right-wing think tank, the American Enterprise Institute. (http://en.wikipedia.org/wiki/American_Enterprise_Institute)

He's in the good company of Lynne Cheney, Newt Gingrich, David Frum, Paul Wolfowitz, Ambassador Bolton... barf.

He's also touted as one of the most under-qualified, inept, and prejudiced former deputy commissioner of the FDA (cronyism in the Bush Administration http://www.time.com/time/press_releases/article/0,8599,1109304,00.html)

So.. my point is don't be surprised if a former Bush appointee, current fellow at the AEI, and "partner to a firm that invests in health-care companies" (bottom of the WSJ article) isn't so hot about health care reform.

That said.. Here's an important point about the American College of Surgeons. They supported the house version of the bill that recently passed in the senate (http://www.facs.org/hcr/hr3200faqs080309.pdf).

You're not going to get this from Mr. Gottlieb.

They indeed do not support the bill that passed in the senate (http://www.facs.org/hcr/reid120109.pdf)

My point here is... there are things that they support whole-heartedly in both bills, and there are things that they definitely disagree with. I only point this out, because when I read Mr. Gottlieb's article, I got the impression that the American College of Surgeons was simply not jiving with the bills in the house and senate AT ALL.

This is not the case. Just read the ACS letters and they'll lay out explicitly what they're in favor for, and what they're against, in both bills.
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BTW... Bump.

LOLing at the thread topic: "ObamaCare Targets Specialized Physicians and Surgeons"

😴
 
teenmachinery1 said:
The AMA goes, point by point, why they oppose the new consultation codes.

They did NOT mention lower medicare reimbursement.

Possibilities:
1. They forgot
2. They didn't look into it

Oops. Strange thing to leave out, I guess.
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You keep focusing on the AMA letter but what about the AAN letter I linked? What about the AMA website I linked where you can plug in the CPT codes and you can see that the "replacement" codes pay less than the consultation codes? In addition to that, why are many doctors, especially in consultation heavy specialties (such as neurology), opposed to the elimination of consultation codes if it doesn't negatively affect them?

Just because CMS says the payments won't decrease or increase doesn't mean it's true. I've shown you that the replacement codes generally pay less than the consultation codes. So, how can you still say that Medicare payments won't be affected? That CMS letter you linked says that they increased the RVUs for new and established office visits (which consults should now be billed as), which is what I've said in my previous posts, but I've also shown you that this increase doesn't compensate for the decrease in RVUs due to the elimination of consultation codes.

Table 1 of this Archives of Internal Medicine paper also shows that the new patient codes pay less than the outpatient consultation codes: http://archinte.ama-assn.org/cgi/content/full/nmed.2009.446?home#ISA90003T1
 
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teenmachinery1 said:
BTW... Bump.

LOLing at the thread topic: "ObamaCare Targets Specialized Physicians and Surgeons"

😴
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Hahaha, you bumped a thread that was idle for 8 minutes??? Listen, it looks like you guys both have valid points with sources. Frankly, I'm leaning towards thinking that a change in consultation codes will = less money for certain fields.
 
Kaushik said:
You keep focusing on the AMA letter but what about the AAN letter I linked? What about the AMA website I linked where you can plug in the CPT codes and you can see that the "replacement" codes pay less than the consultation codes? In addition to that, why are many doctors, especially in consultation heavy specialties (such as neurology), opposed to the elimination of consultation codes if it doesn't negatively affect them?

Just because CMS says the payments won't decrease or increase doesn't mean it's true. I've shown you that the replacement codes generally pay less than the consultation codes. So, how can you still say that Medicare payments won't be affected? That CMS letter you linked says that they increased the RVUs for new and established office visits (which consults should now be billed as), which is what I've said in my previous posts, but I've also shown you that this increase doesn't compensate for the decrease in RVUs due to the elimination of consultation codes.

Table 1 of this Archives of Internal Medicine paper also shows that the new patient codes pay less than the outpatient consultation codes: http://archinte.ama-assn.org/cgi/content/full/nmed.2009.446?home#ISA90003T1
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Oops! Looks like you missed this post:

If we're arguing about what CMS is going to do, Why don't you READ what they say they're going to do?

"
In the calendar year 2010 Medicare Physician Fee Schedule (MPFS) final rule with comment period (CMS-1413-FC), the Centers for Medicare & Medicaid Services (CMS) eliminated the use of all consultation codes (inpatient and office/outpatient codes) for various places of service except for telehealth consultation G-codes. The change will not increase or decrease Medicare payments. "

http://www.cms.hhs.gov/MLNMattersArt...ads/MM6740.pdf

http://www.healthcarefinancenews.com...-payment-codes

In the AMA's letter of opposition to the change in codes to the Secretary, they go through, point by point, their reasons for opposing the code in changes. http://www.ama-assn.org/ama1/pub/upl...lay-letter.pdf Decreased compensation is NOT stated as a reason. Nothing like that is stated as a reason.

Read the CMS pdf. Read the AMA letter.

Don't believe in the boogeyman.
 
teenmachinery, instead of spamming a post again and again, why don't you actually read what I wrote? I've provided actual numbers to show that the new codes pay less than the consultation codes. I even provided an Archives of Internal Medicine paper, which supports my statement that the new codes pay less than the consultation ones. All you've done so far is spam an AMA letter because it doesn't mention decreased reimbursements (even though I've mentioned that it affects high consultation heavy specialties and not so much the less consultation heavy ones) and write in big letters and underlining/bolding it.

Where are your numbers? Where's your actual data other than what a letter says? Are you going to blindly believe a letter that shows no hard numbers instead of looking at the numbers yourself?
 
mipp0 said:
Health care should be a right buddy...and you want to be a doctor?

The only problem is that it's a right we can't afford :laugh:

I loathe the Republicans...I've lost faith in the Democrats...ugh...Life sucks when you're an Indie man.
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Life must suck when you're an idiot, too. 🙄
 
Kaushik said:
teenmachinery, instead of spamming a post again and again, why don't you actually read what I wrote? I've provided actual numbers to show that the new codes pay less than the consultation codes. I even provided an Archives of Internal Medicine paper, which supports my statement that the new codes pay less than the consultation ones. All you've done so far is spam an AMA letter because it doesn't mention decreased reimbursements (even though I've mentioned that it affects high consultation heavy specialties and not so much the less consultation heavy ones) and write in big letters and underlining/bolding it.

Where are your numbers? Where's your actual data other than what a letter says? Are you going to blindly believe a letter that shows no hard numbers instead of looking at the numbers yourself?
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thats not from the ama letter. Smart guy. It's from the actual cms website. :/
 
Medicare is controlled and operated by the government. If you don't like it don't take patients who use it.
 
Kimaris said:
Medicare is controlled and operated by the government. If you don't like it don't take patients who use it.
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easier said than done. not everyone has that luxury, especially with our aging population.
 
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Good Lord.

Guys it is very simple.

As a specialist I bill all new patients as a consult. Currently the reimbursement for a Level 5 consult pays about $220 (depending on state); the Level 5 for a new patient (which is what will "replace" the consult codes) pays about $50 less.

The CMS statement that they won't increase or decrease Medicare payments (so brightly bolded through this thread) simply means that they aren't going to change the payment for the Level 5 new patient code.

So, if the Level 5 new patient pays me $50 less than what I am used to being paid for a Level 5 consult, then yes...I will make less money unless I cut overhead or work harder.

Its that simple and has nothing to do with the proposed 21% across the board decrease. The above will take place Jan 1, 2010.

As for not taking Medicare, it won't make a difference. My practice only has about 11-12% Medicare patients. EVERY insurance company bases their rates on Medicare rates. Medicare cuts its reimbursement and so does BC/BS, Aetna, Tricare, United, etc. Don't be so naive to think that not taking Medicare will make a difference unless you refuse to take all insurance (which is not reasonable for most practices).
 
Winged Scapula said:
Good Lord.

Guys it is very simple.

As a specialist I bill all new patients as a consult. Currently the reimbursement for a Level 5 consult pays about $220 (depending on state); the Level 5 for a new patient (which is what will "replace" the consult codes) pays about $50 less.

The CMS statement that they won't increase or decrease Medicare payments (so brightly bolded through this thread) simply means that they aren't going to change the payment for the Level 5 new patient code.

So, if the Level 5 new patient pays me $50 less than what I am used to being paid for a Level 5 consult, then yes...I will make less money unless I cut overhead or work harder.

Its that simple and has nothing to do with the proposed 21% across the board decrease. The above will take place Jan 1, 2010.

As for not taking Medicare, it won't make a difference. My practice only has about 11-12% Medicare patients. EVERY insurance company bases their rates on Medicare rates. Medicare cuts its reimbursement and so does BC/BS, Aetna, Tricare, United, etc. Don't be so naive to think that not taking Medicare will make a difference unless you refuse to take all insurance (which is not reasonable for most practices).
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Great post.
 
Thanks for the clarification WS. teenmachinery, you should read what she wrote instead of spamming your post again. It doesn't mean that the new codes pay the same as the consultation ones; it just means that Medicare won't change how much those codes currently pay. And I showed you that the new/established patient codes generally pay less than the consultation codes. So, I was right in what I said.
 
Damn it, this is why sometimes I feel China has it right to an extent. To get anything done here in the US, everyone has a say ... even the ******ed ones that are massively influenced by external sources. We need someone MORAL who can rise above petty human nature and just make decisions.

This is too much of an ideal though cause everyone is greedy and base. Ain't nothing gonna change until people forgo their basic self interested instincts and start looking out for everyone's best interest. Kind of a moot point now huh?
 
Further clarificaiton: now what is *supposed* to happen is that the RVUs for E&M Codes (ie, what I bill for when I see a patient) will increase.

Supposedly the global payments for surgical procedures is supposed to increase as well.

However, no one has told me exactly how much the RVUs will increase and if it will definitely offset the decrease in payment going from a Consultation code to a New Patient Code. Most of us think it will not. The American College of Surgeons think that it will be a wash what with the increased global period payments; however, if you have a highly office based practice, that may not be the case (ie, if you make more money seeing consults in the office than in the OR which is the case for me).

But we shall see and if I remember I will report back and let you know what happens in a few weeks. I am still not sure why this needed to be changed (ie, the elimination of codes).
 
Thanks WS,

It's about time that someone stepped in and cleared this nonsense up!
 
I really hope Obama's plan provides a boost for PCP's salaries, we have huge shortages and need more of them.
 
thamsenman said:
I really hope Obama's plan provides a boost for PCP's salaries, we have huge shortages and need more of them.
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Same, but I don't think it will be substantial, and specialists will still make more. Furthermore, I'm not sure how evenly all 'PC' fields will get a bump. For example, will OB/GYN get a bigger bump than peds, but smaller than FM or IM, etc? I also saw a CMS chart recently which said ophthalmology is getting an 11% increase in medicare reimbursement and that some were trying to label it as a PC field??? It's complicated, but I think you'll see a slightly smaller gap between specialists and PC guys, mainly because specialists will make less, not because PC will start pulling in 300k.
 
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Winged Scapula said:
The CMS statement that they won't increase or decrease Medicare payments (so brightly bolded through this thread) simply means that they aren't going to change the payment for the Level 5 new patient code.
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Nope. That's not what the CMS statement means at all. Read any of the latest CMS press releases to figure this out.

Winged Scapula said:
Its that simple and has nothing to do with the proposed 21% across the board decrease. The above will take place Jan 1, 2010.
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This is false and funny that it comes from someone who's seeing and billing patients.

Winged Scapula said:
As for not taking Medicare, it won't make a difference. My practice only has about 11-12% Medicare patients. EVERY insurance company bases their rates on Medicare rates. Medicare cuts its reimbursement and so does BC/BS, Aetna, Tricare, United, etc. Don't be so naive to think that not taking Medicare will make a difference unless you refuse to take all insurance (which is not reasonable for most practices).
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Can you name one of these insurance companies that are changing their rates because of the changes in medicare reimbursement? I'll save you the time, no you can't.
 
Winged Scapula said:
Supposedly the global payments for surgical procedures is supposed to increase as well.

However, no one has told me exactly how much the RVUs will increase and if it will definitely offset the decrease in payment going from a Consultation code to a New Patient Code. Most of us think it will not. The American College of Surgeons think that it will be a wash what with the increased global period payments; however, if you have a highly office based practice, that may not be the case (ie, if you make more money seeing consults in the office than in the OR which is the case for me).

But we shall see and if I remember I will report back and let you know what happens in a few weeks. I am still not sure why this needed to be changed (ie, the elimination of codes).
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So.. The ACS, CMS, and I agree. You don't get it or believe it. That's fine with me.
 
thamsenman said:
I really hope Obama's plan provides a boost for PCP's salaries, we have huge shortages and need more of them.
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I don't know about the salaries but I believe PCP reimbursement from medicare will go up more than other fields.
 
teenmachinery1 said:
Nope. That's not what the CMS statement means at all. Read any of the latest CMS press releases to figure this out.



This is false and funny that it comes from someone who's seeing and billing patients.



Can you name one of these insurance companies that are changing their rates because of the changes in medicare reimbursement? I'll save you the time, no you can't.
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teenmachinery, once again, you're wrong. That is what the CMS statement means. I suggest you reread it again. WS's posts have always been insightful and I trust her understanding of the coding system better than yours. Not only that, I've provided you actual numbers regarding this, which you continually seem to avoid addressing. Even if it's "budget-neutral" for Medicare, it won't be for many practices. Will a 2 to 6 percent increase in work RVUs for new/established patient codes offset the 12 to 40 percent differential Medicare now pays for consultations? Look at the links I've provided if you don't believe. Or you can spam your same post again and again.

When WS said "The above will still take place Jan 1, 2010" she's talking about the elimination of the consultation codes, not the 21% cut. And she is right. The consultation codes will be eliminated. So, unless you misread her, you're wrong yet again.

Every single insurance company follows Medicare rates. They all pay a percentage of what Medicare pays (ie. 167% of the Medicare rate, etc.). You should really research into this before, ignorantly, stating that changes in Medicare reimbursement don't affect private insurance rates.
 
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Winged > Teen .... end of discussion.
 
JaggerPlate said:
Winged > Teen .... end of discussion.
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Why think when you can just appeal to authority. With this mindset, I guess you excused yourself from this discussion a long time ago.

(Hunter would not approve)
 
teenmachinery1 said:
Why think when you can just appeal to authority. With this mindset, I guess you excused yourself from this discussion a long time ago.

(Hunter would not approve)
Click to expand...
But teen, you've done the same thing though. Instead of looking at actual numbers and thinking for yourself, you kept pointing to 1 sentence from the CMS letter and kept saying that if CMS and AMA don't mention it in their letters, it possibly can't be true. You've refused to do the thinking yourself. A little hypocritical, no?
 
The specialized physicians have been having a smooth ride...It is about time for the primary care physicians the be well compensated for their dedications and services. GO OBAMA ..GO...
 
Kaushik said:
But teen, you've done the same thing though. Instead of looking at actual numbers and thinking for yourself, you kept pointing to 1 sentence from the CMS letter and kept saying that if CMS and AMA don't mention it in their letters, it possibly can't be true. You've refused to do the thinking yourself. A little hypocritical, no?
Click to expand...

Sigh..

I said if we're disputing what the CMS says, then let's see what they said. They have repeatedly said in the PDFs and other sources that I cited in my previous posts, as well as in their press releases, that although the codes will change, the medicare reimbursements for consultations will not (legally - CANnot) go down. In fact, they will stay the same or even increase.

Winged dude or whatever agrees with this and stated so above. He says (winged dude) that globally there will be an increase in the medicare consultation reimbursement rates. He just doesn't trust them and there is definitely confusion on the issue. (note the AMA letter that I cited above for this).

Listen, there's confusion on this topic that is shared by many organizations, politicians, and this board.

Even the ANA (which you cited above), said that there was going to be, in general, an INCREASE in neurology consultation reimbursement fees starting in 2010. They said this mid this-year.

I'm kind of bored talking about this though, so maybe we can agree to disagree? (w/e that means!) And perhaps, we can get back to the topic of convo. I tried to do this earlier by bumping myself. :/

👍
 
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