Neurology & Pain Management Coding Alert

2005 fee schedule brings a 1.5 percent increase across the board

CMS has unveiled its "Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005," and it brings some good news for neurology practices. Specifically, CMS has increased the Medicare conversion factor to $37.8975 for 2005, up from $37.3374 in 2004 - an increase of about 1.5 percent.

Medicare payers use the conversion factor, along with the relative value units (RVUs) assigned to individual CPT codes, to determine reimbursement amounts. For example, the fee schedule assigns 1.72 RVUs to 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study). To determine payment, multiply the RVUs (1.72) by the conversion factor (37.8975), for a total of $65.18.

Payments are also subject to geographic adjustments. In more expensive parts of the country, Medicare will pay more to cover higher costs for facility fees, malpractice costs and physician effort, while in less expensive locales Medicare will allot less for the same procedure.
 
You can view the complete text of the 2005 fee schedule revisions at http://www.cms.hhs.gov/regulations/pfs/2005/1429fc.asp.

At the same address, you can also find a complete list of RVUs for all CPT codes in "Addendum B" to the fee schedule update, as well as a complete list of geographic adjustments in "Addendum D."