2014 MPFS Proposed Rule Cuts 24 Percent
In a proposed rule published in the July 19 Federal Register, the Centers for Medicare & Medicaid Services (CMS) proposes payment policy and rate changes to the 2014 Medicare Physician Fee Schedule (MPFS). Not surprising, the rule includes a negative 24.4 percent update to the 2014 rates used to pay physicians for services covered under Medicare Part B.
The 24.4 percent pay cut is calculated by dividing the estimated 2014 conversion factor ($25.7109) by the 2013 conversion factor ($34.0230) and subtracting 1.
This calculation is based on the sustainable growth rate formula, which has been at the root of negative updates compounded over the years. Congress will undoubtedly put a Band-Aid on the problem as it has every year, rather than come up with a permanent resolution to what everyone can agree is a flawed methodology, and physicians won’t likely see their Part B claims payments reduced by one-forth.
Other provisional changes in the proposed rule more likely be finalized in November include:
- Adjusting nearly 200 misvalued PFS codes
- Expanding telehealth services
- Including outpatient therapy services furnished by critical care hospitals in the therapy caps
- Requiring compliance with state law as a condition of payment for services furnished incident-to physician and other practitioner services
- Making numerous revisions to the Medicare Economic Index (MEI)
- Updating ambulance fee schedule regulations
- Updating the:
- Physician Compare website;
- Physician Quality Reporting System (PQRS);
- Electronic Health Record (EHR) Incentive Program; and
- Medicare Shared Savings Program
- Creating budget neutrality for the Chiropractic Services Demonstration
- Changes to the Physician Value-based Payment modifier and the Physician Feedback Reporting Program
Some of these provisions will create but a ripple in your practice, while others may make some waves.
See the 2014 MPFS proposed rule to learn more about these and other policy and rate changes, and look for in-depth coverage of specific provisions in this proposed rule in AAPC News online and in AAPC Cutting Edge.