General Surgery Coding Alert

Watch for final rule and Congressional changes.

There may be some winners and losers this year under the Medicare Physician Fee Schedule (PFS) proposed rule, but it won't general surgeons.

Here's the low-down on what you can expect if CMS makes no changes in the final rule, and if Congress fails to avert the sustainable growth rate (SGR) update for 2013.

Surgeons Lose to Primary Care Physicians

To offset a pay increase to some physicians under the primary care initiative, CMS proposes to hold steady or decrease pay for all non-primary care physicians, including general surgeons. Although some specialties face extreme fee reductions (up to 14 percent), general surgeons can expect to hold steady with a 0 percent pay change, according to CMS.

Here's why: CMS is proposing a 7 percent pay increase for family practitioners, and between 3 and 5 percent increases for other primary care practitioners. "Helping primary care doctors will help improve patient care and lower health care costs long term," said CMS Acting Administrator, Marilyn B. Tavenner in a statement about the proposed PFS.

That's not all: As it has every year since CY 2002, CMS projects a significant reduction in PFS payment rates under the SGR methodology. For CY 2013, CMS projects a reduction of 27 percent. Congress has acted to avert the cuts every year since 2003, however. That means the waiting begins now to see if the 27 percent reduction materializes.

Keep an eye on future issues of General Surgery Coding Alert to see if any changes in the final rule or Congressional action will impact your bottom line.