Thanks to last minute votes by both the Senate and House of Representatives, Medicare physician reimbursement rates will remain at the 2012 level through 2013. The SGR cuts slated to go into effect on January 1 were averted when the House of Representatives passed the American Taxpayer Relief Act, also known as the Middle Class Tax Relief Act. The Senate approved the package earlier in the day.
The following health provisions were included in this bill:
Current Medicare physician payment rates extended through December 31, 2013 (avoids SGR cuts).
Geographic Work Adjustment extended through December 31, 2013.
Sequestration cuts deferred for two months (2% cut in Medicare payments and larger program cuts for other health programs, e.g. research/public health/health professions training).
“While this vote does not change the RVU cuts to NM and EDX procedural codes announced in early November, it does ensure that the RVU conversion factor will remain at 2012 level for another year,” said Shirlyn Adkins, JD, AANEM executive director. “We will continue to work with CMS this year to gather the data they need to review our procedural codes for future reimbursement decisions.”
Medicare Administrative Contractors have indicated they will be able to immediately accept claims, using the newly-approved SGR formula, and process payments under the typical 14-day cycle required by law. Therefore, it is important that EDX physicians use the new 2013 codes when billing procedures performed after January 1.
More information on the new codes may be found in the AANEM Coding Toolkit