The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would update payment policies and rates for physicians and non-physician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year 2012. More than 1 million providers of vital health services to Medicare beneficiaries – including medical and osteopathic physicians, limited license practitioners such as podiatrists, and NPPs such as nurse practitioners and physical therapists – are paid under the MPFS.
CMS’ proposed rule for Medicare payments to physicians and non-physician practitioners includes a 29% payment rate reduction next year. The portion of the rule impacting physicians also calls for a number of policy changes, including expansion of the billing code initiative to ensure appropriate valuation; payment adjustments accounting for geographic variation in cost of practice; expansion of the multiple procedure payment reduction to include the professional interpretation of advance imaging services; an update of the number of physician incentive programs; and quality and cost measures that would be used in establishing a new value-based modifier to reward physicians for providing higher quality and more efficient care.
In separate filings, CMS proposed a 1.5% increase in hospital outpatient rates and a 0.9 percent increase in ambulatory surgical center payments. CMS projects that total payments under the MPFS in CY 2012 will be $80 billion.has issued proposed changes that will, among other changes, update payment policies and rates for physicians and services to Medicare beneficiaries in hospital outpatient departments.