General Surgery Coding Alert

Expect level pay through March 31, 2015.

You’re probably used to this by now since it has happened each of the past 11 years, but a last-minute law has saved your general surgery practice from a potentially devastating reimbursement loss for services you provide to Medicare beneficiaries. 

That’s because the Protecting Access to Medicare Act of 2014, signed into law on April 1, halted the 24 percent pay cut for Medicare Physician Fee Schedule services that was to go into effect on that day.

Instead, the law replaces the reimbursement cut with a 0.5 percent payment update through the end of 2014 and a zero percent payment update from January 1, 2015 to March 31, 2015.

Don’t Expect a Permanent SGR Fix This Time

Stakeholders had been looking for a permanent fix to the Medicare sustainable growth rate (SGR) formula that leads to these looming pay cuts every year, but it was not to be.

Many industry groups are lamenting the lack of a long-term solution.

AMA’s thoughts: In a press release, the American Medical Association (AMA) states that it is “deeply disappointed.” The AMA goes on to say: “Remarkable progress was made this past year in reaching a bipartisan, bicameral agreement on policy to repeal the SGR, and the AMA encourages Congress to continue its work and resolve outstanding issues.”

“Full repeal of the sustainable growth rate formula is the answer to strengthening the Medicare program, not another patch,” AMA president Ardis Dee Hoven said in a statement in response to the bill.

“The SGR needs to be fixed permanently by Congress,” agrees Catherine Brink, BS, CMM, CPC, CMSCS, president of Healthcare Resource Management, Inc. in Spring Lake, NJ. “The temporary fix at least keeps practices’ Medicare revenue on track for now anyway.”