Learn what's possible, and watch for final rule and Congressional changes. There may be some winners this year under the Medicare Physician Fee Schedule (PFS) proposed rule, but it won't be pathologists and clinical labs. Here's the low-down on what you can expect if CMS makes no changes in the final rule, and if Congress fails to avert the sustainable growth rate (SGR) update for 2013. Pathologists Lose to Primary Care Physicians To offset a pay increase to some physicians under the primary care initiative, CMS proposes to decrease pay for all non-primary care physicians, including pathologists. Expect a 1 percent reduction for pathology, according to CMS. Here's why: CMS is proposing a 7 percent pay increase for family practitioners, and between 3 and 5 percent increases for other primary-care practitioners. "Helping primary care doctors will help improve patient care and lower health care costs long term," said CMS Acting Administrator, Marilyn B. Tavenner in a statement about the proposed PFS. Don't forget that you're already facing a 1 percent reduction for pathology in 2013 as the final year of the four-year practice-expense (PE) transition. That totals two percent down for pathology. That's not all: Expect Lab Cuts, Too Labs can anticipate a 4.95 percent payment cut in 2013 for tests paid on the clinical laboratory fee schedule (CLFS), based on current law. Look at the following adjustments to see how it adds up: Keep an eye on future issues of Pathology/Lab Coding Alert to see if any changes in the final rule or Congressional action will impact your bottom line.