2010 Medicare Physician Fee Schedule Update

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  • November 30, 2009
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The Centers for Medicare & Medicaid Services (CMS) has issued a corrected 2010 Medicare Physician Fee Schedule (MPFS), available on its Web site.

Updated PFS relative value units (RVUs) include technical corrections for CPT® codes G0341, 29870, 36481, 37183, 47382, 50200, 55873, 92610, 99221, 99222, 99223, 99304, 99305, and 99306.

The 2010 conversion factor contained in the 2010 MPFS final rule has also been modified. The 2010 conversion factor is now $28.3895, instead of $28.4061 as previously indicated in the final rule.

CMS indicated that a correction notice will be published in the Federal Register regarding these corrections, but did not specify when.

No Responses to “2010 Medicare Physician Fee Schedule Update”

  1. Denise D Miller CPC says:

    When are we getting the new modifier for H&P`s?

  2. Cindy McGarry CPC-P says:

    At an audio conference yesterday, we were told that the new modifier for the admitting physician will be AI (the letter I, not number 1).

  3. Rebecca Lopez says:

    A live webninar from MGMA dated 11.18.09 and the presentors were Nancy Enos,Joan Gilhooly. They have on the handout that the Modifier A1 ( one).
    ” The admitting/attending physician of record will be requried to append the specific modifer to the initial hospital care or initial nursing facility care code which will identify him or her as the admitting physician of record who is orverseeing the patient’s care, Preliminary indication are the modifier will be A1″
    Hopefully some one can clarify!

  4. Susan Hedges says:

    Say it isn’t so Rebecca! That is just going to be a nightmare if the modifier is required by the “admitting physician”. We might as well just stop doing inpatient consults altogether!
    I am so annoyed that the Gov’t has to constantly make it more difficult for the honest physicians to make a living instead of figuring out ways to only get rid of the ‘bad guys’.
    DECREASING income, eliminating consults (which also decreases income), all while REQUIRING docs to conform to E-Scripting, EHR, ICD-10 in the future……..really? who in their right mind would aspire to be a Doctor these days? How sad that our country is going this way. Can’t wait until I’m 65
    Thanks for letting me vent. 🙂

  5. Louise Rodriguez says:

    This may be a dumb question, but I went to CMS website, and even my trailblazer health (regional medicare) website and cannot find where the fee schedule is…any suggestions? would be appreciated…thanks Louise

  6. Mary Ellen Fletcher says:

    Hi Louise,
    The final rule may be found at:
    http://edocket.access.gpo.gov/2009/pdf/E9-26502.pdf and the fee schedule begins on page 281 of the document. CPT codes begin on page 283. Hope this helps.

  7. Holly McDaniel says:

    Does anyone know if there will be new codes for hospital consults cpt codes 99254 & 99245. They are deleted in MCR fee schedule.

  8. Peggy Smith CPC says:

    Hi all
    Per the CMS website:
    AI Principal Phy of Record
    AF Specialty Phy
    AG Primary Phy
    A1 Dressing for 1 wound
    Hope this helps

  9. Nancy Enos, FACMPE CPC-I CEMC says:

    Rebecca, The modifier has not been officially announced by CMS. You are correct, the 2010 HCPCS modifier list includes AI as “PRINCIPAL PHYSICIAN OF RECORD”.
    A Carrier Director mentioned A1 as a possible modifier at the AMA’s CPT symposium. It was not official, and it was mentioned in the MGMA webinar as “unofficial” pending CMS clarification.

  10. shana says:

    where did you find your information on the different modifiers?

  11. Tom Stickel, CPC says:

    I’m seeing about 20% reduction from 2009. Does anybody concur? I guess it’s a bad time to quit my Lexapro.

  12. Peggy Smith CPC says:

    On the CMS website. I put it on my post under the A1 modifier.

  13. Peggy A says:

    I tried following the link the CMS web-site for the modifiers AI,Af and AG, but it didn’t take me to the right place. Can you forward to me again, please?

  14. Louise Rodriguez says:

    Thank you Mary Ellen I appreciate your help!

  15. Liz G says:

    How do we find the link that give the description of modifier AI, AF AG?

  16. Barbara F says:

    The link for the new Medicare HCPCS is long but here goes:
    Look for the “10anweb.xls” (win zip file)
    You may otherwise search for: 2010 Alpha-Numeric HCPCS File in the CMS website.

  17. Jennifer Yarnall, CPC says:

    Hi everyone,
    As Tom Stickel mentioned in the above comment, Medicares new fee schedule for 2010 did decrease by 18% to 19%. I was doing research for my doctors on the elimination of consultation codes when I stumbled across this disturbing revelation. My practice consists of pulmonoligists and my doctors are going to loose it when they find out that not only is Medicare eliminating consultations, but now they’re decreasing payment for E&M codes as well? Talk about adding insult to injury! I hope they don’t shoot the messenger. According to the article I read in CHESTS’ website, Medicare was suppose to offset the elimination of the consult codes by increasing payment for outpatient/office codes by 6% and initial hospital visit codes by 2%. Can anyone tell me what is going on? This is a nightmare!

  18. Julie Larson says:

    To Tom and Jennifer,
    I too have noticed the 20% decrease, and have yet to find anything anywhere in regard to this. I was looking for the “2% to 6% increase” but it seems to be evading me also! I’m meeting with my docs tonight and they are aware of it, but I am still taking my Lexapro!!

  19. Susan Hedges says:

    Unfortunately it is only after I did an analysis of the projected loss of income that I realized that Medicare IS increasing the reimbursement for E/M codes but ONLY AFTER decreasing the entire fee schedule by 21.2%! That’s like saying ‘you’re getting a 6% raise (YAY!) BUT we have to cut your salary by 15% (YIKES!)
    Not sure why the gov’t thinks it is feasible to promote pay cuts to everyone but themselves. If Congress doesn’t stop this fee schedule cut from happening (and stop the yearly time wasting of going through this situation time after time) I’m pretty sure we’re going to have to start going out of the country just to FIND a Dr. Who wants to waste half their life in Medical school paying astronomical tuition only to be paid less than the school janitor?
    Well, at least Medicare finally published the process for billing Inpatient codes as admits.
    Good luck everyone!

  20. Jamie says:


  21. Jamie Claypool CPC says:

    If and when these modifiers are confirmed by the CMS are they to be used only on hospital services?What about in the office?

  22. stephanie says:

    My billing company is telling me that AI is invalid not in their system. Should I tell them to update their system or do we have to use the AI code when billing? I’m so confused now!

  23. Annette says:

    Modifier AL would be used for Principal Physician of Record

  24. TAMARA TAYLOR says: