Wiki 2013 Medicare Fee Schedule

[Summer]

Good morning,
Yesterday Medicare posted an update:noted below.

Are you holding your claims for the first 2 weeks of January?
Thank you.


Attention health professionals: Information regarding the 2013 Medicare physician fee schedule
The negative update of 27 percent under current law for the 2013 Medicare physician fee schedule (MPFS) is scheduled to take effect on January 1, 2013.

MPFS claims for services rendered on or before December 31, 2012, are unaffected by the 2013 payment cut and will be processed and paid under normal procedures and time frames.

The Administration is disappointed that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk. The Centers for Medicare & Medicaid (CMS) continues to urge Congress to take action to ensure these cuts do not take effect. Given the current progress with the legislation, CMS must take steps to implement the negative update.

Under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. CMS will notify you on or before January 11, 2013, with more information about the status of congressional action to avert the negative update and next steps

 

[ckmiotek]

We hold our Medicare claims every year for the month of Jan. However, our practice is primarily Commercial insurances. So holding Medicare claims for a month is only 3% of our accounts receivable. For offices that are primarily Medicare I am sure this is not case.

 

[AprilSueMadison]

Now what happens? Congress signed a new law, made adjustments...but when will the medicare fee schedule be updated to reflect that there is no 27% cut?

I'm new to this and trying to figure out answers so I can report back to our office manager. They certainly don't teach this stuff in school.

 

[mhstrauss]

It will probably take the carriers a couple of days at least to update and repost the corrected fee schedules to their websites. Last year, the new one was put up effective 1-6-12; we had Pinnacle then. But now have Novitas. We are hoping to see it soon; I've been checking their site almost religiously looking for it!

 

[ndupre]

Our Internal Medicine practice is 60% Medicare and we will hold our claims for at least the next week. We also had Pinnacle last year (I miss them) and now have Novitas. I am already impatient that Novitas has not posted anything about when to expect the fee schedule to be updated. We began holding claims every January a few years ago after dealing with a large volume of claims that had to be adjusted after a last minute change to the fee schedule. Never again! To prepare our clinic for January financial impacts, at the end of every November/ beginning of December I coordinate with our office manager to estimate how much income we need to cover expenses in December and go from there; sometimes even holding daily collection/ pvt insurance paper check deposits at the end of December until after Jan 1. We are a 5 provider group practice owned by 1 physician, therefore we are set up financially where we don't want a lot of money in the bank at the end of the year for tax purposes. The extra income recieved the first week in January benefits us not only because of the fee schedule situation (where there isn't a gaurantee of on time fee schedule fixes), but also because of decreased overall beginning of the year collections due to Medicare patients struggling to pay their deductibles. This year I held claims for 2 weeks in the beginning of December and submitted them on Dec 17th. We recieved the EFT/RA deposit yesterday, perfect timing to cover payroll, which is due today