Anesthesia Coding Alert

Key: Increased risk may mean loss

If you take time to compare facility and non-facility reimbursement for some pain management procedures, you'll find that many show a negative change from 2004 to 2005. But if the 2005 conversion factor (CF) increases in 2005, the idea that your overall pay may drop probably baffles you.

Some experts believe it might be because the government is encouraging physicians to perform the procedures in an office rather than a hospital or ambulatory facility.

"The cost savings are significant, and the burden switches to the physician," explains Abraham Rivera, MD, CEO of Pain Management Medical Group in Albany, N.Y.

Many physicians are eager to accept the burden if the additional reimbursement correlates with the increased overhead. But once you add all the costs, the margin for success is quite small.

"Physicians must make a sizeable investment to safely and adequately perform these procedures in their offices," Rivera says. "Any miscalculations in the thin financial line can ruin a private physician who may not have the financial resources to weather a reimbursement storm."