CMS: Medicare Reimbursement Rates Won’t Be Cut in 2012

The Centers for Medicare & Medicaid Services (CMS) Transmittal 1058, Change Request (CR) 7767 confirms a zero percent update for payments under the Medicare Physician Fee Schedule (MPFS) through year’s end.

Medicare payments were slated for a 27.4 percent cut as of Jan. 1, 2012. Congress acted on Dec. 23, 2011 to forestall the cuts for the first two months of 2012; and on Feb. 22, President Obama signed into law the Middle Class Tax Relief and Job Creation Act of 2012 (MCTRJCA), extending the zero percent update through Dec. 31, 2012.

Also included in the MCTRJCA are extensions to:

  1. the moratorium that allows certain pathologists and independent laboratories to bill for the technical component (TC) of physician pathology services furnished to hospital patients through June 30, 2012;
  2. the exceptions process for Medicare therapy caps; and
  3. the continuation of the Medicare physician work geographic adjustment floor.

The MCTRJCA discontinues the minimum payment for bone mass measurement, as well as MPFS mental health 5 percent add-on payments.

Almost every year for a decade, Medicare expenditures have surpassed targets and the sustainable growth rate (SGR) used to determine Medicare payments has called for substantial cuts. Since 2003, Congress has intervened to prevent these SGR-mandated reductions. The deferments do not abolish the SGR, but only allow mandated payment cuts to accumulate. Without an SGR fix, expected reductions will top 30 percent in 2013.


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