CMS Proposes Policy, Payment Rate Changes For 2012 Physician Fee Schedule

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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.

Read the proposed rule.Read the press release.