Oncology & Hematology Coding Alert

If you were holding your breath for a Medicare pay increase, you can finally exhale.

In December, the Senate and House passed the Medicare, Medicaid and SCHIP Extension Act of 2007, replacing the scheduled 10.1 percent Medicare pay cut for 2008 with a 0.5 percent increase. The bill became law on Dec. 29.

The downside: The law expires on June 30, so Medicare allowances after that are still up in the air.

"This is a political football," says David C. Harlow, Esq., of The Harlow Group. "Congress has never let the sustainable growth rate (SGR) rules kick in. I don't think that they will let them kick in mid-year."

Despite the congressional reprieve, however, physicians should not take their attention off of the legislative wrangling that will be required to fix payments after June 30, says Jean Acevedo, LHRM, CPC, CHC, PCS, of Acevedo Consulting Inc. "They should be worried that come July 1, 2008, their reimbursement will drop to the 10.1 percent reduction," she says.

Potential upside: "I-ve never seen Congress attempt just a six-month fix," Acevedo says. "Maybe the Senate is planning to actually tackle the core problem with the fee schedule between now and June. If so, that could actually be good news."

The new ruling also extends the PQRI program, the 5 percent bonus provision to physicians who practice in physician scarcity areas, the geographic index floor of 1.0, and the therapy cap exceptions process, among other provisions.

Learn more: To read a breakdown of the bill, visit http://www.senate.gov/~finance/press/Bpress/2007press/prb121807.pdf.