Medical Society of Virginia

Final rule sets in motion 24 percent Medicare pay cut on Jan. 1

5 December 2013

On Wed., Nov. 27, the Centers for Medicare and Medicaid Services (CMS) released its final rule with the 2014 Medicare physician payment schedule. Although the rule is nearly a full month late, it is still scheduled for implementation Jan. 1, 2014. Unless Congress acts before it adjourns for the year, which it is scheduled to do in mid-December, physicians face a 20.1 percent cut in the Medicare conversion factor due to the sustainable growth rate (SGR). When adjustments to the relative value scale are combined with the conversion factor change, the net reduction in payment rates will be about 24 percent.

Although Congress seemed poised to pass a bi-partisan bill to repeal and replace the SGR formula earlier this year, reports from Washington this week indicate that it is unlikely that they will do so before Jan. 1. It is more likely that Congress will pass a 90-day patch and attempt to reach consensus on a final bill in 2014.

Contact Congress and tell lawmakers to fix Medicare now.

In addition to the SGR cut, the rule addresses several key issues.
  • Beginning in 2015, CMS will establish separate payments for managing a patient’s care outside of face-to-face visits to recognize the critical role primary care plays in providing care to beneficiaries with multiple chronic conditions.
  • Revises the geographic criteria and eligible services for telehealth reimbursement.
  • Updates the geographic practice cost indices and Medicare economic index.
  • Requires compliance with state-level incident-to requirements.

Click here for the final rule or click here for additional information on the physician payment rates for 2014. Click here to find the updated Medicare deductible, coinsurance and premium rates updates and be sure that your billing staffs are aware of these changes.

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