Medicare Physician Fee Schedule Changes for 2009
As a result of Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), many physicians likely expected a 1.1% increase in overall payment for Medicare services in 2009. However, due to a new calculation of the conversion factor for 2009, Medicare payment for many physician services will decrease. As finalized, the Medicare Physician Fee Schedule (MPFS) conversion factor will go from $38.0870 in 2008 to $36.0666 in 2009, an expected decrease of 5.3%.
Medicare Part B-covered physician-administered drugs that are separately payable, such as REMICADE® (infliximab), will continue to be reimbursed at a rate of average sales price (ASP) plus 6%.
Each year the CMS recalculates the reimbursement rates for physicians. The new payment rates are effective January 1, 2009-December 31, 2009.1
1 73 Federal Register 69725, 70238 (2008).
Coverage policies may vary by insurer or even between plans offered by the same insurer. This information is presented for informational purposes only and is not intended to provide reimbursement or legal advice. Laws, regulations, and policies concerning reimbursement are complex and are updated frequently. While we have made an effort to be current, the information may not be as current or comprehensive when you view it. Please consult with your counsel or reimbursement specialist for any reimbursement or billing questions.