2011 MPFS Proposed Rule Stands Corrected

  • By
  • In Billing
  • September 10, 2010
  • Comments Off on 2011 MPFS Proposed Rule Stands Corrected

Several technical and typographical errors have been identified in the 2011 Medicare Part B Physician Fee Schedule (MPFS) proposed rule since its July 13 release. Although the corrections the Centers for Medicare & Medicaid Services (CMS) subsequently posted Aug. 22 in the Federal Register do not constitute rule-making, some of the changes are worth noting.

Corrections of note in the 2011 MPFS proposed rule:
On page 40136, Table 39 is corrected by adding level 3 established patient office or other outpatient visit CPT® code 99213 as a primary care service eligible for primary care incentive payments in 2011.
On page 40180, regarding the Physician Quality Reporting Initiative (PQRI) group practice reporting option (GPRO), quality measures are grouped into four disease modules, which include “heart failure; hypertension; and preventive care services.” The proposed rule fails to mention hypertension.
On page 40186, regarding the proposed PQRI measures, measure 135 Chronic Kidney Disease (CKD): Influenza Immunization was erroneously included in Table 51, which lists the 2010 PQRI quality measures that are not proposed for inclusion in the 2011 PQRI quality measures. As a result, the number of 2010 measures that will be retained in 2011 was incorrect. In the corrections document, CMS removes measure 135 from Table 51 and adds it to Table 52, page 40189 (which lists the proposed 2011 quality measures from the 2010 PQRI quality measures set) and Table 58, page 40194 (which lists the proposed 2011 CKD Measures Group).
On page 40244, regarding the proposed anti-switching requirement, “switching beneficiaries” is changed to “incentivizing beneficiaries to switch;”  and “suppliers generally do require beneficiaries to switch” is corrected to “suppliers generally do not require beneficiaries to switch.”
The corrections document was published in the Aug. 22 Federal Register.


No Responses to “2011 MPFS Proposed Rule Stands Corrected”

  1. Julie Van says:

    Great work! This is very pertinent and will be very helpful–especially to those of us interested or participating in PQRI. Thanks!