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February 14, 2018

Select States and Territories to Be First to Receive New Medicare Cards

The Centers for Medicare and Medicaid Services announced its mailing strategy over the course ... Learn More

New Payment Model Qualifies as APM

The Centers for Medicare and Medicaid Services (CMS) is rolling out a new payment model to begin ... Learn More

MAO Provider Directories Frustrate Would-Be Patients, CMS Finds

In a review completed in August 2017, the Centers for Medicare and Medicaid Services (CMS) dis... Learn More

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Medical Coding News Archives

Physician Payment Takes Major Blow for 2008

November 13, 2007:
The final rule for updates to the physician fee schedule isn’t pretty, at least as far as physician payment is concerned. It looks like physicians will see a negative 10.1 percent update in Medicare fee-for-service payment rates unless Congress takes action.

The Centers for Medicare and Medicaid (CMS) has no choice but to implement this negative update because it is mandated by a statutory formula.

Under the new rule, released November 1, the agency estimates that it will pay approximately $58.9 billion to about 900,000 physicians and other health care professionals. The rule, which becomes effective January 1, 2008, also includes quality incentive rates and related policy changes. Included in the policy changes are:
  • Additions to the list of telehealth services
  • Payment for covered outpatient drugs and biologicals
  • Payment for renal dialysis services
  • Revisions to bone mass measurement (BMM) services policies,
  • The physician self-referral prohibition
  • Laboratory billing for the technical component (TC) of physician pathology services
  • The clinical laboratory fee schedule
  • Certification of advanced practice nurses
  • Health information technology and the health care information transparency initiative
  • Updated the list of certain services subject to the physician self-referral prohibitions
  • finalized ASP reporting requirements
The rule also discusses Medicare’s longstanding policy that payment of bad debts associated with services be paid under a fee schedule/charge-based system. In addition, CMS finalized interim relative value units (RVUs) and issued interim RVUs for new and revised procedure codes.

Deborah C. Hall
Clinical/Technical Editor


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