Medicare Fees Reward Some, Punish Others

Total Medicare payments to family physicians could increase 7 percent and fees for other physicians providing primary care could rise 3 to 5 percent, due mostly to a proposal to create new payment codes for outpatient discharge care management. Payments to some specialists would decrease in the Centers for Medicare & Medicaid Services' (CMS') proposed 2013 Medicare Physician Fee Schedule. However, unless Congress intervenes again, CMS will slash overall Medicare payments 27 percent next year because of the Sustainable Growth Rate formula.;

Table 84 that begins on page 683 of the 764-page proposal shows the impact of fee schedule's impact on allowable charges for each specialty.

"Helping primary care doctors will help improve patient care and lower health care costs long term," CMS Acting Administrator Marilyn B. Tavenner said in a news release.

The proposed rule, which also includes some new rules for the upcoming physician value-based purchasing adjustments and many other payment changes, will appear in the July 30 Federal Register. CMS will accept comments on it until Sept. 4 and issue a final rule by Nov. 1.


Action, July 16, 2012


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