Part B Insider (Multispecialty) Coding Alert

But anesthesiologists boost their pay by one-third

The Centers for Medicare & Medicaid Services (CMS) announced that your Medicare payments will drop 10.1 percent in January--even more than the 9.9-percent cut you were bracing for. Just imagine calculating all your payments with a conversion factor of 34.0682. That's the terrible reality you-ll face in January unless Congress acts soon.

-This is disgraceful,- says Maxine Lewis with Medical Coding Reimbursement Management in Cincinnati. -Medicare Advantage groups have received an increase,- while doctors receive pay cuts. -How does the government believe that a business can operate on a reduction of 10 percent?- she asks. Doctors may have to limit the number of new Medicare patients they take on if this becomes final, she predicts.

-The legislature has always found a way to not really enforce these expected cuts but this may be the year [a reduction] really happens,- warns Marcella Bucknam, manager of compliance education with the University of Washington Physicians.

The looming cut is a good reason to make sure you-ve mastered the Physicians Quality Reporting Initia-tive (PQRI) to -get every penny out of the process,- adds Bucknam.

The new 2008 physician fee schedule final rule did offer some  positive news:

- Your anesthesiologist will be getting a massive pay hike next year. CMS decided to go ahead and increase the work value of almost all anesthesia services by 32 percent.

Tradeoff: A raise for anesthesia means pay cuts for other doctors, notes Bucknam. Anesthesiologists see a total pay hike of 14 percent next year, but cardiologists, ED doctors, interventional radiologists, neurosurgeons and some other surgeons will all see a 2-percent drop in their payments due to work RVU and practice expense RVU changes.

And because anesthesiologists don't have as much overhead as other doctors, the pay hike may be a little excessive, say some experts.

Anesthesiologists can supervise up to four Certified Registered Nurse Anesthetists, notes Suzan Hvizdash, physician educator for the University of Pittsburgh Physicians Dept. of Surgery.

- CMS is holding off on finalizing most of its controversial Stark self-referral rules. 

Go online to www.cms.hhs.gov/center/physician.asp to see the new regulation.