Medicare Physician Fee Schedule Changes for 20101
On October 30, 2009, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2010 Medicare Physician Fee Schedule (MPFS) Final Rule. Physicians were slated to see a 21.2 percent cut in Medicare physician payments starting January 1, 2010.
However, on December 19, 2009, President Obama signed legislation to delay the scheduled cuts from taking effect through February 28, 2010. Congress will need to take additional action in order to prevent cuts or payment reductions after that date.
Most Medicare Part B-covered separately payable drugs and biologicals such as REMICADE® will continue to be reimbursed based on Average Sales Price (ASP) + 6 percent.
The Final Rule with comment was published in the Federal Register on November 25, 2009.
The new payment rates and policies will apply to services furnished to Medicare beneficiaries between January 1 and December 31, 2010.
For an updated 2010 Medicare Physician Fee Schedule, please visit www.cms.gov or contact your regional Medicare Part B contractor for additional details.
1 Federal Register, Vol. 74 No. 226, November 25, 2009, Rules and Regulations.
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.
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BILLING AND REIMBURSEMENT