Practice Management Alert

There's good news for anesthesiologists, but not for other providers If the proposed 2008 physician fee schedule that CMS released in July goes through as planned, the reimbursement for services your physician provides to Medicare patients will face a 9.9 percent cut next year. Prepare Now for Shortfalls in January Bad news: The biggest losers, according to the proposal for 2008, would be cardiologists, emergency physicians, hand surgeons, interventional radiologists, nephrologists, neurosurgeons, rheumatologists, thoracic surgeons and vascular surgeons. The biggest winners from the new rule would be anesthesiologists, audiologists, optometrists, nuclear medicine physicians, geriatricians and dermatologists. What should you do: -The best a practice can do now is to build up cash reserves; billers/collectors should collect every dollar allowed,- says Gail Lorenzen, CHBC, senior consultant with The Sage Group in Phoenix. Get up and running with the Physician Quality Reporting Initiative (PQRI) program as well, says Denae M. Merrill, CPC-E/M, coder for Covenant MSO in Saginaw, Mich. -At the least, you get ready for what could become mandatory in the future, and at best, you get a little extra money for your efforts.-
Be Cautiously Hopeful Congress Will Act There is some hope: Congress may step in to save you from such a steep cut just as it has done for the past few years. Congress acted at the very last minute to prevent a reduction to your reimbursement in January 2007 by approving and passing a freeze that keeps the conversion factor (CF) at the current 2006 rate of 37.8975 instead of decreasing it to the scheduled 2007 rate of 35.9848. -I don't get worked up about the -proposed- cuts until well into that year because, for the past couple of years, they seem to do something to help keep payments from going down,- Merrill says. No one can guess yet whether Congress will step in again for next year, experts say. -However, even if Congress steps forward and reduces the 9.9 percent cut, there are other subtle areas that will be cut regardless of Congress,- Lorenzen says. Example: The budget neutrality work adjustor will be reduced to 0.8816 from 0.8994 next year. This means your physician's work payments will drop another 1.7 percent in 2008, mainly affecting your E/M reimbursement, Lorenzen says. One of the most frequently billed services, 99213 (Office or other outpatient visit for the evaluation and management of an established patient ...), will be reduced from $59.50 to $58.73 even without any change in the conversion factor. -A practice's payments are calculated from a formula based on three components: physician work, practice expense, and malpractice, all adjusted for geographic variations,- Lorenzen says. -Changes to any of these elements impact your payments.- In addition: Your geographic [...]