Medicare Participation Deadline Is Feb. 14

Physicians have until Feb. 14 to determine their Medicare participation status for 2012. The Centers for Medicare & Medicaid Services (CMS) extended the annual enrollment period from the original deadline of Dec. 31 after Congress delayed the 27.4-percent cut in payments to physicians through February.

CMS said the effective date for any participation status change during the extension, however, remains Jan. 1 and will be enforced for the entire year. According to CMS, contractors will accept and process any participation elections or withdrawals that are postmarked on or before Feb. 14.   

As of this writing, TMA had not calculated a Medicare fee schedule for 2012. This is because the bill that delayed the Medicare payment cut also extended the work geographic price cost indices (GPCIs) floor through February. CMS will have to calculate new geographic adjustors before TMA can calculate the new fee schedule. The new fees will be calculated with the new relative value unit (RVU) file that is available on the CMS website but using the 2011 conversion factor and the new, as yet uncalculated, geographic adjustors. TMA staff experts say that in most cases, the new, temporary fees will be close to, but not the same as, the 2011 fees. 

Physicians who are Medicare participating providers can submit claims using their standard charge, and Medicare carriers will be able to pay claims properly as soon as they have appropriate instructions from CMS. Submitting claims using 2011 Medicare allowables or estimated allowables could result in underpayment, as it did in 2011.   


Action, Jan. 3, 2012


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