The Centers for Medicare and Medicaid Services (CMS) Oct.
30 released the final 2009 Medicare Physician Fee Schedule,
which includes some good news for cardiology in terms of administrative
burden, but some unfortunate news about physician payment.
While ACC staff continues to review the rule in detail, highlights
include the following:
CMS is deferring a final decision on its proposal to require
physician practices that provide diagnostic testing services
to register as IDTFs . The ACC, working in coalition with
other cardiovascular societies, has opposed the proposal because
it would create significant administrative burdens on practices
without necessarily increasing the quality of diagnostic testing
provided. CMS explained that the passage of the Medicare Improvements
for Patients and Providers Act (MIPPA) in July 2008 was one
reason that it decided not to finalize this proposal at this
time. MIPAA includes accreditation requirements for providers
of the technical component of advanced imaging in order to
be paid for services provided to Medicare patients beginning
in 2012. The ACC strongly supported this component of MIPPA.
Although MIPPA put in place a 1.1 percent update to the Medicare
conversion factor, CMS projects that overall Medicare payments
to cardiology will fall by 2 percent in 2009. This cut results
primarily from two policy changes. First, the third year of
the four-year transition to a new formula for calculating
practice expense relative value units (RVUs) will reduce payments
for a number of cardiovascular imaging services. Second, MIPPA
requires that the current budget neutrality adjustment applied
to work RVUs be incorporated into the conversion factor. As
a result, payments for services with a significant practice
expense element (imaging procedures, in-office procedures)
will receive a reduced payment. Conversely, services with
more physician work elements (evaluation and management, interventional
cardiology and electrophysiology procedures performed in a
hospital) will have payments increase by more than 1.1 percent.
CMS also announced the payments for a series of new codes
related to cardiac device monitoring, as well as new bundled
codes that describe transthoracic echocardiography with spectral
and color flow Doppler and stress echocardiography with stress
ECG monitoring.
The final rule increases the bonus payment for PQRI participation
to 2 percent and adds additional reporting methods, including
using the ACC's IC3 Program as a reporting alternative. Physicians
in 2009 may also receive a separate 2 percent bonus for qualified
e-prescribing, as created under MIPPA. The ACC is developing
educational tools to assist members in learning how to participate
in each of these programs.
Watch www.acc.org and upcoming
issues of Cardiology magazine for additional information on
the final rule and upcoming Webinars explaining the various
provisions.
Related Resources:
The ACC and MedAxiom will hold a Webinar on November 14 from
2:00 to 3:30 p.m. EST to discuss changes to cardiac device
monitoring coding structure. Register
now!
Click here to
read more information on the effects of the Medicare Physician
Fee Schedule on payment for echocardiography services.
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