Pediatric Coding Alert

Question: Two of our insurers follow the Medicare fee schedule in assigning fees, and we read your article about the projected 27 percent conversion factor cut with interest. Has this cut gone into effect?

Alabama Subscriber

Answer: No, fortunately the cut has not gone into effect. Although the government appeared poised to take a big bite out of your next payments, you have another two months before you need to worry about losing pay. That's because the 27 percent cuts that practices have feared since last fall were kicked to the curb by Congress, resulting in a Medicare Physician Fee Schedule conversion factor of $34.0376 through Feb. 29.

Problems aren't over: Although Medicare pay is now set to drop on March 1, the AMA is hopeful that Congress will find a longer-term solution before then. "With this brief reprieve from the massive 27 percent cut to Medicare payments, Congress now has to enact a real and fiscally responsible solution to this sorry cycle of scheduled cuts and short-term patches that compromises access to care for patients and drives up costs for taxpayers," AMA President Peter W. Carmel, MD, said in a statement. "Members of Congress need to use this time to work in a bipartisan manner to provide long-term stability for seniors, military families and the physicians who care for them."

Pediatricians should remember that although Medicare payments may not seem directly applicable to them, almost every payer in some way, shape or form bases payment to them on the Medicare fee schedule.