Medicare Sequestration Cuts, GPCI Floor Continue
By David Doolittle

APM_Options

As we begin 2020, it’s a good time to remember that several Medicare policies that affect physician payment remain in effect.  

Medicare sequestration, the federal government’s 2% across-the-board payment cut, will continue until further notice. The cut is applied to all claims after coinsurance, deductible, and Medicare secondary payment adjustments. 

The sequestration, which is required by the Budget Control Act signed into law in August 2011, will continue until further notice, said Novitas Solutions, Texas’ Medicare payer. You can find more information on Novitas Solutions’ website

In addition, Medicare’s 1.0 floor for the Geographic Practice Cost Indices (GPCI) has been extended temporarily, once again, to May 23. 

The GPCI is one of the factors the Centers for Medicaid & Medicare Services (CMS) uses to calculate physician payments, based on the cost of doing business in different parts of the country. 

The 1.0 floor was set to expire Dec. 31, 2019, which would’ve caused some physician payments to fall. However, the extension was granted in an appropriations bill President Donald J. Trump signed in December. Congress will vote on the extension again in May.

Last Updated On

January 07, 2020

Originally Published On

January 07, 2020

Related Content

Insurance | Medicare

David Doolittle

Editor

(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

More stories by David Doolittle