Coding & Reimbursement News Archive
Ophthalmologists See Significant Boost in Final 2010 Physician Fee Schedule
The 2010 Medicare physician payment final rule released on Oct. 30 will be published in the Federal Register on Nov. 25. Comments are due on Dec. 30. As the Academy reported last week, the rule establishes a 2010 payment update of -21.6 percent due to the series of short-term sustainable growth rate (SGR) fixes. The Academy is working to ensure Congress intervenes and eliminates the faulty SGR formula before Jan. 1. We also continue to seek a permanent repeal of the SGR.
In what is a substantial victory for ophthalmology, CMS has finalized adoption of the new practice expense (PE) survey that sets ophthalmology up for an 11 percent increase over four years. Even with a four-year phase in — a CMS compromise to several of the groups whose payments are significantly decreasing — ophthalmology will receive a 3 percent PE increase next year. That, combined with changes to professional liability insurance relative values for another 2 percent increase, brings ophthalmologists a total published increase of 5 percent in 2010, if the negative SGR update is halted.
Important Medicare Enrollment Update
CMS has indicated that MDs are incorrectly filling for enrollment or practice location changes via internet based PECOS. A Medicare contractor will not process an Internet enrollment application without the signed and dated two-page Certification Statement and the required supporting documentation. Physicians must return the Certification Statement within seven of the electronic submission.
> Getting Started: Internet-based PECOS (PDF 52K)
> Medicare Program Integrity Manual (PDF 512K)
Notice of New Interest Rate
Notice of New Interest Rate for Medicare Overpayments and Underpayments (Part A and B) — Effective July 21, 2010, the interest rate for-overpayments and underpayments will be 11.00 percent. Medicare Regulation 42 CFR §405.378 provides for the assessment of interest at the higher of the current value of funds rate (one percent for calendar year 2010) or the private consumer rate (PCR). The Department of the Treasury has notified the Department of Health and Human Services that the PCR rate will be 11.00 percent.
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