CMS Issues Final Rule on Physician Fees for 2013

On November 1, the Center for Medicare & Medicaid Services released a final rule for 2013 on the payments that Medicare will issue for physicians’ fees. Several items in the rule are notable. First, the rule includes a required 26.5 percent reduction to Medicare payments. At this point, it is unclear whether Congress will accept the reduction in light of increased calls for fiscal restraint or whether it will continue to deny the reduction. Assuming that Congress does reject the reduction, payment to primary care practitioners may increase by anywhere from three to seven percent.

The rule also finalizes several changes made to the Meaningful Use and PQRS incentive programs, and will make a series of additional incentives available over the next several years. In addition, it includes new policies allowing for reimbursement for care coordination services provided for up to 30 days following certain kinds of treatment in a hospital or skilled nursing facility. Finally, certified registered nurse anesthetists will now be included in the group of professionals that may be reimbursed by Medicare, to the extent of any service they may provide under state law. These changes are the primary causes of the projected increase in payment to practitioners; however, this increase is contingent on Congress’s action with regard to the final rule.

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