ED Coding and Reimbursement Alert

Formula driven cuts avoided with interim Conversion Factor of $35.8228

At least for the first three months of 2014, the Medicare physician conversion factor will increase along with your Medicare payments.

The skinny: President Obama signed the Pathway for SGR Reform Act of 2013, which prevented a scheduled 20.1% cut in physician pay due to the sustainable growth rate (SGR) formula. The conversion factor will be $35.8228 starting Jan. 1, which is a 5.3 percent increase over the $34.0230 conversion factor in place at the end of 2013. The Pathway for SGR Reform Act of 2013 allows Congress more time to pass a permanent repeal of the flawed SGR formula by the time the temporary fix expires on March 31.

The good news for EDs continues with the extension of the physician work geographic price cost index (GPCI) artificial floor through the end of March. The 1.0 floor on the physician work geographic practice cost index will keep your geographic work values at least at the national allowable level. This is a significant step for EDs in rural areas that would have seen cuts if the artificial floor expired. Historically, this adjustment has been tied to previous SGR patches; however, stay tuned to future issues of ED Coding and Reimbursement Alert for news on any permanent SGR fix legislation Congress considers in the coming months.