2009 MPFS Final Rule: Tidings of Joy

Physicians and non-physician practitioners (NPPs) who provide health care to people with Medicare can expect a pay hike next year, but just how much depends on their willingness to accept the conditions put forth in the 2009 Medicare Physician Fee Schedule (MPFS) final rule.

According to the 2009 MPFS final rule with comment period, which the Centers for Medicare & Medicaid Services (CMS) issued Oct. 30, physicians may qualify for a payment increase ranging anywhere from as little as 1.1 percent to as much as 5.1 percent.

As mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPAA), which became law July 15, physicians will receive a 1.1 percent fee schedule update in 2009. That’s better than the 5.4 percent cut they would’ve endured if the bill had not passed. The preliminary estimate for the sustainable growth rate for 2009 is 7.4 percent, and the conversion factor is $36.0666—up from 34.0682.

Physicians and NPPs may be eligible to receive an additional 4 percent in payment incentives.

Physicians can earn 2 percent of their total Medicare allowed charges if they adopt and use qualified e-prescribing systems to transmit prescriptions to pharmacies, and another 2 percent incentive payment for successfully reporting measures under the Physician Quality Reporting Initiative (PQRI).

In other news …

CMS is reversing the modifications to the computer generated facsimile exemption in the 2008 MPFS final rule and reinstating the original computer-generated facsimile exemption that was adopted in the 2005 MPFS final rule.

Also with the final rule, physicians and NPPs can bill for follow-up inpatient consultations for more appropriately with the new HCPCS Level II codes CMS intends to add for telehealth services.

The final rule also includes new policies on several other subjects imposed by MIPAA, such as changes to the initial preventive physical examination (IPPE) policy, the floor on geographic adjustment to the physician work component, ambulance payment rate, the payment rate for oxygen equipment, supplies and maintenance, the end-stage renal disease composite rate, and more.

For details on the general provisions of the 2009 MPFS rule, as well as CMS’s implementation of the PQRI and e-prescribing initiative, and MIPPA changes, see the CMS Fact Sheets. You can also download a PDF of the 2009 MPFS final rule.

The 2009 MPFS final rule will appear in the Nov. 19 Federal Register. Comments on designated provisions are due by 5 p.m. ET on Dec. 29. CMS says it will publish a final rule responding to the comments at a later date.


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One Response to “2009 MPFS Final Rule: Tidings of Joy”

  1. Jenny Berkshire, CPC, CPC-GI, CPC-E/M says:

    This is the first I’ve read about reimplementation of the follow up inpatient consultation codes. I hope to get more information as soon as it is available.

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