2010 Medicare Physician Fee Schedule Proposed Rule Published

On July 1, the CMS released the proposed changes to the Medicare Physician Fee Schedule (MPFS). CMS updates the MPFS annually to set payment rates for physician and non-physician practitioner services. The press release is found on the Medical Release Database section within CMS: http://tinyurl.com/kqsdym.

Highlights of this Proposed rule include:

•  Explanation that Physician Practice Information Survey (PPIS) data should be used when updating the practice expense component of physician fees. The PPIS is a survey conducted and designed by the American Medical Association.
• CMS reducing rates for physician payments.
• Stoppage of payment for consultation codes and base payments on existing E/M service codes.
• Increased payment rates for the Initial Preventive Physical Exam (the “Welcome to Medicare” visit).
• Implementation of new programs for cardiac and pulmonary rehabilitations services and for chronic kidney disease education.
• Revisions to the Electronic Prescribing Incentive Program (e-Prescribing Program) and the Physician Quality reporting Initiative (PQRI). Eligible professionals or group practices that meet the requirements of the program will be eligible for incentive payments equaling up to two percent of their total estimated allowed charges.
• New proposals for additional PQRI measures (22 measures and 6 measure groups) and reporting from electronic health records (streamline process and provide more options).

The entire proposal is published in the July 13, 2009, Federal Register: http://edocket.access.gpo.gov/2009/pdf/E9-15835.pdf  And overview of the  changes to the PQRI and Electronic Prescribing Incentive Programs can be found in this Fact Sheet, published July 1, 2009: http://tinyurl.com/lm5eqm.

Comments may be submitted electronically by going to the following web site: http://www.regulations.gov/search/Regs/home.html#documentDetail?R=09000064809f0082  and clicking on”Submit Comment” link at the top of the page to view the Public Comment and Submission Form. Comments are accepted through August 31, 2009. The final rule will be published November 1, 2009.

Written by: Kathy Lindstrom, a professional coder at Provation and a CCH & MediRegs Coding Advisory Board member.