Ophthalmology and Optometry Coding Alert

Medicare Physician Fee Schedule rate won't be cut 23 percent.

Although the government appeared poised to take a big bite out of your next Medicare Part B payments, you now have another month before you need to worry about losing pay. That's because the 23 percent Medicare Physician Fee Schedule conversion factor cut that practices have feared since January was once again kicked to the curb by Congress.

On Nov. 18, the Senate voted to halt the Medicare physician pay cut for one month, and the House returned from Thanksgiving break on Nov. 29, at which point they also voted to freeze Medicare pay through the end of 2010.

As most practices know, last June, Congress voted to not only delay a 21 percent cut to your Medicare pay, but to increase your revenue by 2.2 percent. However, that vote only kept the cuts at bay through November 30.

Medicare pay is set to drop 25 percent effective Jan. 1, 2011, and the current legislation does not change that. During a Nov. 16 CMS Open Door Forum, CMS reps decided to elucidate information included in the 2011 Medicare Physician Fee Schedule Final Rule, which was recently released.

"The rule is written under current law, which means that it takes into account the schedule of negative updates to the SGR," said CMS's Amy Bassano during the call. "If the law were to change, we would put out revised files and rates to reflect any changes in the law," she noted.

Bassano ran down several important points that you don't want to miss in the 2011 Fee Schedule, including the following: Effective Jan. 1, deductibles will be eliminated for most preventive services, as prescribed in the Affordable Care Act, and the 20 percent coinsurance for those procedures will be waived as well. See the Fee Schedule for specifics on which preventive services are covered under this policy.