The U.S. Centers for Medicare and Medicaid Services (CMS) has proposed changes to the Medicare Physician Fee Schedule (MPFS) that it believes will improve the accuracy of payments to physicians for services provided to Medicare beneficiaries.
The proposed notice addresses two components of physician payments under the MPFS: a comprehensive review of physician work relative value units (RVUs) and a proposed change in the methodology for calculating practice expenses. The proposal includes a 37% increase for "evaluation and management" RVUs for family medicine and general practitioner physicians.
According to the American College of Radiology (ACR) of Reston, VA, in order to pay for the increase, Medicare is proposing to apply a minus 10% work adjustment to all physician work RVUs as a budget-neutral adjustment. However, Medicare is proposing to use a special method that does not change the RVUs in the MPFS but changes the dollar payments calculated for the payors, the ACR said.
In addition, CMS said that it is proposing changes to the way Medicare calculates the practice expense portion of MPFS payments. CMS will use a bottom-up method for calculating direct costs, in which it uses the actual dollar values of clinical time, supplies, and equipment for direct costs and would then use ACR practice survey data to calculate the added indirect costs for radiology.
To ease the implementation of the change in the practice expense methodology for physician practices and to ensure continued beneficiary access to services, CMS is proposing a four-year transition to the new practice expense RVUs.
The ACR reported that it has calculated the charge impact of the proposed changes, when fully implemented in 2010, to be a -3% decrease for radiology but a 2% gain for radiation oncology. Interventional radiology will see a -8% charge impact, while vascular surgery will receive a 1% gain. Cardiology and pathology, according to the ACR, will see a -4% and a -7% decrease, respectively.
The proposed notice will appear in the June 29 Federal Register. Comments will be accepted until August 21 this year, CMS said.
By AuntMinnie.com staff writers
June 27, 2006
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