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Medical Coding News Archives

Conversion Factor Is Adjusted Downward

May 28, 2010:

On May 10, 2010, the Centers for Medicare and Medicaid Services released a revised conversion factor of $36.0791 (as opposed to the existing factor of $36.0846).

The new conversion factor was announced in Transmittal 700, “Revised Payment Files for the 2010 Medicare Physician Fee Schedule Database (MPFSDB) and Retroactive Provisions under the Patient Protection and Affordable Care Act” (Pub. L. 111-148) (the Affordable Care Act).

Because of revisions to the practice expense (PE) and malpractice (MP) relative value units (RVUs) to align their values with the final calendar year 2010 MPFS policies, the conversion factor (CF) has had to be revised, superseding the 0 percent update to the 2010 MPFS that was extended through legislation for claims with a date of service on or before June 30. The effective date for the revised conversion factor of $36.0791 is retroactive to January 1.

The transmittal also included information about modifications resulting from the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. These laws include the extension of several provisions that had previously been included in other legislation. The following provisions have been extended:

  • The work geographic practice cost index (GPCI) floor of 1.0
  • The MPFS mental health add-on
  • The exceptions process for Medicare therapy caps
  • Payment for the technical component of certain physician pathology services

Also included is a slight revision to the PE geographic practice cost indexes (GPCIs) for CY 2010 and a new provision regarding payment for bone density tests in CY 2010.

Deborah C. Hall
Clinical/Technical Editor


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