Wednesday, Nov. 7, 2012
This Week's News
This Week's News
CMS finalizes Medicare fee schedule for 2013, confirms 26.5 percent cut
The 2013 Medicare fee schedule final rule issued last week by the Centers for Medicare & Medicaid Services (CMS) makes a number of positive changes but also underscores the need for congressional intervention to avoid a massive payment cut on Jan. 1.
Among the key AMA recommendations included in the 1,362-page final rule is payment for certain care coordination services and adoption of CPT® codes to report them. CPT codes 99495 and 99496 will be used for the new transitional care management services.
"The AMA appreciates that CMS recognizes the value of these services for improving the overall quality of health, as this rule supports physicians working in emerging models of care and the work involved in transitioning patients from one care setting to the next," AMA President-Elect Ardis D. Hoven, MD, said in a statement.
CMS also has added an appeals process for physicians who are participating in Medicare's ePrescribing program and two new penalty exemptions for physicians who also are participating in the meaningful use electronic health records program.
Meanwhile, the final rule confirms that physicians who care for Medicare patients will see a 26.5 percent cut in payments Jan. 1 if Congress does not intervene.
"The release of the Medicare physician fee schedule rule reminds patients, physicians and Congress that the time to act to prevent looming Medicare cuts is now," Dr. Hoven said. "Eliminating the failed [physician payment] formula will allow us to enter a period when physicians can begin transitioning to new payment and delivery models to help meet the overall goal of improving patient care and moving to a higher performing Medicare program."
Read more about the AMA's principles for transitioning to a high-performing Medicare program in a recent blog post by AMA President Jeremy A. Lazarus, MD.