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March 27, 2018

Spring OPPS Update Released

The Centers for Medicare and Medicaid Services (CMS) summarized the spring update to the outpatie... Learn More

Therapy Caps Repealed and Payment for Therapy Assistant Services Lowered

Medicare payment caps on outpatient therapy were permanently repealed effective January 1, 2018. ... Learn More

OIG Update Work Plan, Studies Cardiac Device Credits

In March, the Office of Inspector General (OIG) posted several updates to its existing Work Plan,... Learn More

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Medical Coding News Archives

Congress Passes Legislation To Prevent Physician Reimbursement Cut

December 26, 2007:
Late December 19th, Congress passed legislation to prevent the negative 10.1 percent update to the physician fee schedule conversion factor and instead, allowed for a 0.5 percent increase. This means that the estimated conversion factor is 37.9165 instead of the 34.0682 published in the final rule.

However, unlike previous years, this legislation does not run through all of 2008. Instead, the bill only provides the update for the first six months of 2008. Congress is planning to make a permanent fix to the formula for updating physician payment during the first half of 2008. Without intervention by July 1, physicians could be looking at even deeper cuts in reimbursement for the last half of 2008. Ingenix will keep you posted during that time.

Other elements of the Medicare, Medicaid and SCHIP Extension Act of 2007 include:
  • Extending the current funding of the SCHIP program until March 31, 2009;
  • Continued incentive payments for successful participation in the Physician Quality Reporting Initiative for all of 2008
  • Extension of the 5 percent bonus payment to physician shortage areas through June 30;
  • Continuing the geographic practice cost index floor of 1.0 through June 30;
  • Continuing the current “charges to cost” methodology that provides a separate payment for brachytherapy beginning April 1, including therapeutic radiopharmaceuticals;
  • Permits reimbursement for certain diabetes laboratory tests for home use at the same rate as other glycated hemoglobin tests beginning April 1.


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