Pulmonology Coding Alert

Question: What conversion factor is in effect for 2007?

New Jersey Subscriber

Answer: 37.8975. The Tax Relief and Health Care Act of 2006 set the 2007 conversion factor for physician payment at the same level as in 2006 (37.8975), reversing the statutorily mandated 5 percent negative update. President Bush signed the legislation into law on Dec. 20, 2006, making it good to go.

Be sure to check rates for CPT codes that you commonly use in the National Physician Fee Schedule for 2007. The Act does not maintain 2007 physician payments at 2006 levels. You can easily compare 2007 rates with 2006 rates with an online fee schedule calculator available from medicalmanagement.com.

In addition to freezing the fee schedule rate at 2006 levels, Congress also authorized a 1.5 percent bonus for eligible providers who report quality measures.

And the legislation includes a one-year extension for CY 2007 of the minimum 1.0 floor in the Geographic Practice Cost Index under the fee schedule. This reverses a scheduled reduction in payment to the 51 rural localities where the GPCI is below 1.0 percent.