Podiatry Coding & Billing Alert

But RVU changes still in effect.

Podiatrists can expect a reprieve from the dreaded 2013 pay cut to the Medicare Physician Fee Schedule (PFS). Congress voted to halt the 26.5 percent rate cut that was tied to the sustainable growth rate (SGR) formula.

In addition to freezing Medicare payment rates at the 2012 level through Dec. 31, 2013, the bill also defers the automatic 2 percent across-the-board sequestration cuts for two months. The new 2013 conversion factor is $34.0230.

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Although medical associations were relieved about the continuing Medicare payments for 2013, they lamented the fact that the government had 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.”

“The conversion rate from 2012 will now apply to the 2013 CPT^® Relative values for each code,” explains Barbara J. Cobuzzi, MBA, CPC, CENTC, CPCH, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, a consulting firm in Tinton Falls, N.J. “Please check your Medicare MAC’s website and make sure it has been updated to reflect this change as of the January 1^stcongressional vote. Your encoder, such as Codify, will be reflecting this continuation of the 2012 conversion factor.”

“Note that the fees from 2012 will not necessarily be the same in 2013, because the RVUs for many CPT^® codes have changed,” Cobuzzi explains.