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.


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3 Responses to “2014 MPFS Proposed Rule Cuts 24 Percent”

  1. Lisa Wms says:

    It would be nice if CMS would get the fee schedule complete before the new year!

  2. Lynda H says:

    As a professional coder, over 65 and on Medicare I am appalled to see a proposed cut of 24%. It is hard enough for seniors to find physician who will accept Medicare patients and this cut will just make matters worse. While Congress may come with a bandaid fix, it will be in 2014 after many million claims are paid by Medicare and secondary insurance carriers. The cost of adjusting those payments will be in the millions of dollars, just like always. That cost of postpayment adjustments should be factored into any payment reduction calculations. What a mess.

  3. Veronica Clark says:

    As a Certified Professional coder and office manager I see if the proposed cut is allowed to take place primary care physicians stop taking medicare at all. Primary Care Physicians struggle to continue as it is.

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