CMS Proposes 2012 Physician Fee Schedule

July 6, 2011 – On July 1, 2011, CMS issued a proposed rule that would update payment policies and rates for physicians and nonphysician practitioners for services provided in calendar year 2012.  Some of the highlights of the proposed rule are as follows:

• Unless Congress steps in, the Medicare payments for 2012 would be reduced by 29.5 percent
• CMS will significantly expand the potentially misvalued code initiative, focusing on the highest volume and dollar codes billed by physicians to determine whether these codes are overvalued and if E & M codes are undervalued.
• Propose changes to how CMS adjusts payments for geographic variation in the cost of practice
• RADIOLOGY:  Expand its multiple payment reduction to the professionalinterpretation of advanced imaging services, stating there are overlapping activities that go into valuing these services.
• PRIMARY CARE:  Propose criteria for a health risk assessment (HRA) to be used in conjunction with the Annual Wellness Visits
• PRIMARY CARE:  Propose to expand the list of services that can be furnished through telehealth to include smoking cessation services
• Update the incentive programs including PQRS, eRx and the EHR Incentive Programs
• Proposed quality and cost measures that would be used in establishing a new value based modifier that would reward physicians for providing higher quality and more efficient care.
• Implement the third year of a 4-year transition to new practice expense relative value units
• ASCs:  0.9 percent update to payments for CY 2012
• ASCs:  Implement a quality reporting program for ASCs by proposing eight quality measures beginning in  CY 2012 for the CY 2014 payment determination.

CMS will accept comments on this proposed rule until August 30, 2011 and will review and respond to all comments in a final rule to be issued by November 1, 2011.

We will be reporting on some of these proposals in our future newsletters.

To read the proposed rule, click below:

July Physician Fee Schedule Proposed rule (link opens in a new window)

Tags: SGR and Medicare Fee Schedule