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Medicare Compliance & Reimbursement

PHYSICIANS:

For You And Your Patients, Talk Isn't Cheap Anymore

Published on Fri Oct 13, 2006

But CMS will reduce your payments by 5 percent overall.

There's good news and bad news for you in the final rule that solidifies the 2007 Medicare Physician Fee Schedule (MPFS). The bad news: You will indeed see a much-debated 5-percent payment reduction next year.

But the good news is that Medicare will pay physicians much more for two of their most-billed services, according to the new MPFS final rule. In the Centers for Medicare & Medicaid Services' (CMS) new initiative to focus on the physician-patient relationship, the final rule increases the work component for the relative value units (RVUs) for evaluation and management services "during which the physician and patient discuss the patient's health status and the steps that can be taken to maintain or improve the patient's health," CMS reports in a Nov. 1 announcement.

Specifically, the final rule provides for a 37-percent increase in the work component for RVUs associated with an intermediate office visit, which is the most frequently billed physician service, the agency says. Also, the RVUs' work component for an office visit that requires moderately complex decision-making will increase by 29 percent and the same type of hospital visit will increase by 31 percent.

"We believe this increase in the work component will encourage physicians to spend more time with their patients, assessing their health status and educating them about how to live longer, healthier lives," acting CMS administrator Leslie V. Norwalk said in a Nov. 1 statement.

The final rule also expands preventive services benefits, including payment for preventive ultrasounds screenings for abdominal aortic aneurysms as part of the "Welcome to Medicare" exam and increasing the number of Medicare beneficiaries who are eligible for bone mass measurement due to long-term steroid therapy, CMS says. The colorectal cancer screening benefit is exempt from the Part B deductible under the final rule, the agency adds.

As a result of the policy and payment changes in the MPFS final rule, CMS expects to pay out approximately $61.5 billion to 900,000 physicians and other health care professionals during 2007. The rule will become effective for services on or after Jan. 1, 2007.

For more changes under the final rule, go to www.cms.hhs.gov/apps/media/press/release.asp?Counter=2044.

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