Practice Management Alert

You won't feel as big a crunch, thanks to neutrality adjustment. CMS unofficially released the Medicare Physician Fee Schedule for next year when they sent it to the Office of the Federal Register. Although the physician community was told they would be seeing a 1.1 percent increase, the conversion factor ultimately is 5.4 percent reduction. Despite a lower conversation factor, however, the news isn't all bleak. In fact, your practice will likely see an increase in reimbursement next year. Here's what you need to know to be ready come January. Some Specialties Fare Better Than Others Don't lose heart when you see CMS- 2009 conversion factor of $36.066 -- a drop from this year's $38.0870. CMS attempts to make up for the practice expense reduction, which lowered the conversion factor by 6.5 percent, by boosting the conversion factor adjustment by 1.1 percent. Therefore, despite the lower conversion factor, the relative value units (RVUs) for some procedures have gone up. What it means to you: The amount your claims will bring in next year depends on the specialty you bill for. Some specialties, such as audiology (10 percent decrease) and cardiology (2 percent decrease), will get hit hard. But while some specialties won't fare as well next year, others will see a distinct boost in reimbursement next year. For example, general surgery practices will see a 3 percent scheduled increase to their pay, and emergency medicine billers can expect their claims to bring in an additional 4 percent next year. Where to find it: The specialty information, which comes from Table 48 in the Fee Schedule Final Rule, shows how the new RVU changes will affect each specialty. You can check other specialties online at http://www.cms.hhs.gov/physicianfeesched/downloads/CMS-1403-FC.pdf. "There is a 6.5-percent, five-year practice expense reduction that has been in the works for the past five years, so without the 1.1 percent increase, we would be seeing a 6.5 percent overall decrease in reimbursement," says Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions. "Instead, we are now seeing a 5.4 percent decrease. Had the planned 10 percent decrease in Medicare fees taken place, the result would have been a 16.5 percent reduction in the conversion factor, and that is huge," she added. 99213 Gets Boost CMS reassigned RVU values for many procedures for 2009. While the RVUs for several procedures went down, your non-geographically adjusted reimbursement for the most commonly-reported code, 99213 (Office or other outpatient visit...) rose. Whereas you currently are allowed $58.90 for 99213 (not including geographic adjustment), you-ll bring in $61.31 for this service in 2009. Allowances (non-geographically adjusted) for 99214 (Office or other outpatient visit...) will rise from the current rate of $89.89 [...]