Pediatric Coding Alert

Permanent solutions to fix this annual problem did not materialize, however.

As many pediatric practices are aware, medical offices nationwide were waiting to find out whether legislators halted a 26.5 percent pay cut that the 2013 Fee Schedule predicted, which would have brought the 2013 conversion factor down to $25.0008. In addition, practices were facing a two percent across-the-board sequestration cut that was set to hit Medicare providers’ payment rates in early 2013. This would have impacted pediatric practices since many private payers take Medicare’s lead when setting rates.

Good news: On Jan. 1, Congress voted on the Middle Class Tax Relief Act, which reversed the 26.5 percent cut and froze Medicare payment rates at the 2012 level through Dec. 31, 2013. The bill also deferred the sequestration cuts for two months.

Although medical associations were relieved about the continuing Medicare payments for 2013, they lamented the fact that the government has not permanently fixed the problem by overhauling the sustainable growth rate (SGR) formula. "This patch temporarily alleviates the problem, but Congress’ work is not complete," said AMA president Jeremy Lazarus in a statement. "It has simply delayed this massive, unsustainable cut for one year. Over the next months, it must act to eliminate this ongoing problem once and for all."