Here is the most recent CAP alert:
CMS Releases Proposed 2009 Physician Fee Schedule
The proposed 2009 Medicare physician payment fee schedule from the Centers for Medicare and Medicaid Services (CMS) will be published next week in the July 7, 2008 issue of the Federal Register.
The proposed rule, which will be open for public comment until August 29th, includes several points of interest to pathologists, including:
A proposed 5.4 percent negative update for physician services;
A proposal to create new G codes for the pathologic evaluation, interpretation, and reporting of saturation prostate biopsies;
A proposal to update prices for high cost supplies used in CMS practice expense methodology
A request from CMS for the RUC to review potentially over-valued services;
Two proposed alternatives to clarify exceptions to the anti-markup rule:
the first proposes to waive the anti-markup rule for physicians who conduct diagnostic testing services as part of a shared practice with a single physician or physician organization; or
the second proposes to clarify the existing anti-markup provision pertaining to what would constitute the the office of the billing physician or other supplier and other concepts such as outside supplier.
Confirmation that the cap on incentive payments under the Physician Quality Reporting Initiative (PQRI) has been removed;
Confirmation to again include the breast and colon cancer reporting measures in PQRI reporting in 2009.
Confirmation that the alternate reporting methods in the rule will not apply to pathologists.
1. How final is the 5.4% cut?
2. Does it apply across the board, or just for pathologists?
3. Is this negative update the effect of 10% cut for Medicare services which is being currently reconsidered by Congress?
4. What do the proposed changes in anti-markup provision mean in plain English?
5 What about the prostate and breast biopsy changes? What are the 'alternate reporting methods'?
CMS Releases Proposed 2009 Physician Fee Schedule
The proposed 2009 Medicare physician payment fee schedule from the Centers for Medicare and Medicaid Services (CMS) will be published next week in the July 7, 2008 issue of the Federal Register.
The proposed rule, which will be open for public comment until August 29th, includes several points of interest to pathologists, including:
A proposed 5.4 percent negative update for physician services;
A proposal to create new G codes for the pathologic evaluation, interpretation, and reporting of saturation prostate biopsies;
A proposal to update prices for high cost supplies used in CMS practice expense methodology
A request from CMS for the RUC to review potentially over-valued services;
Two proposed alternatives to clarify exceptions to the anti-markup rule:
the first proposes to waive the anti-markup rule for physicians who conduct diagnostic testing services as part of a shared practice with a single physician or physician organization; or
the second proposes to clarify the existing anti-markup provision pertaining to what would constitute the the office of the billing physician or other supplier and other concepts such as outside supplier.
Confirmation that the cap on incentive payments under the Physician Quality Reporting Initiative (PQRI) has been removed;
Confirmation to again include the breast and colon cancer reporting measures in PQRI reporting in 2009.
Confirmation that the alternate reporting methods in the rule will not apply to pathologists.
1. How final is the 5.4% cut?
2. Does it apply across the board, or just for pathologists?
3. Is this negative update the effect of 10% cut for Medicare services which is being currently reconsidered by Congress?
4. What do the proposed changes in anti-markup provision mean in plain English?
5 What about the prostate and breast biopsy changes? What are the 'alternate reporting methods'?
