Physician Center
Spotlights
Revised Fact Sheet for Referral Agents - Where are the Round 2 areas? What if a beneficiary travels? What do you need to know before prescribing a DMEPOS item or referring the beneficiary to a DMEPOS supplier? Want more information on the national mail-order program for diabetic testing supplies?
For answers to these questions and more, see the revised “Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program: Referral Agents” Fact Sheet (ICN 900927), which is now available in downloadable format.
- Begin Transitioning to ICD-10 in 2013. Registration is now open for a National Provider Call on April 18 from 1:30-3.
- President Obama Signs the American Taxpayer Relief Act of 2012--New Law Includes Physician Update Fix through December 2013
On Wednesday, January 2, 2013, President Obama signed into law the American Taxpayer Relief Act of 2012. This new law prevents a scheduled payment cut for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2013. The new law provides for a zero percent update for such services through December 31, 2013. This provision guarantees seniors have continued access to their doctors by fixing the Sustainable Growth Rate (SGR) through the end of 2013. President Obama remains committed to a permanent solution to eliminating the SGR reductions that result from the existing statutory methodology. The Administration will continue to work with Congress to achieve this goal. For more information, see January 2 Medicare FFS Provider e-News.
- CMS-1590-FC: Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013. (Published: 11/16/2012)
- Vaccination is the Best Protection Against the Flu [PDF, 414KB]
- Primary Care Incentive Program Payments for 2011 (posted 05/22/2012)
- Blood Clotting Factor Furnishing Fee
- Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
- The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the posting of updated educational materials on Section 6407 of the Affordable Care Act of 2010, which established a face-to-face encounter requirement for certification of eligibility for Medicare home health services. See the "Home Health Face-to-Face" part of the Spotlights section on Home Health Agency (HHA) Center web page.
Medicare FFS e-News Spotlights
- Subscribe now to receive the weekly CMS Medicare FFS Provider e-News for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.
Important Links
Billing / Payment
- Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
- CMS Recognized P-C IOLS and A-C IOLs [PDF, 17KB]
- PFS Carrier Specific Files
- PFS Relative Value Files
- PFS National Payment Amount File
- Electronic Billing & EDI Transactions
- National Correct Coding Initiative Edits
- Physician Fee Schedule
- Sustainable Growth Rates & Conversion Factors
- Competitive Acquisition for Part B Drugs & Biologicals
- Historical Part B Drug Pricing Files
- Physician Bonuses
- Consolidated Billing
- SNF Consolidated Billing
- Psychological and Neuropsychological Tests
- Telehealth
- Service Furnished to Undocumented Aliens
Enrollment/ Participation/ Certification
- CMS 460 (90 KB) [PDF, 216KB] About Medicare Participation: Information about accepting assignment.
- Medicare Provider-Supplier Enrollment
- Enrollment Applications
- Survey & Certification - General Information
Policies/Regulations/Legislation
- PFS Federal Regulation Notices
- Quarterly Provider Updates
- Federal Advisory Committee Act (FACA)
- Physician Regulatory Issues Team (PRIT)
- Physician Self Referral
- Emergency Medical Treatment & Labor Act (EMTALA)
Education
- MLN General Information
- MLN Educational Web Guides
- MLN Matters Articles ( Search Tips )
- MLN Products
- Prevention - General Information - Information on various activities geared toward disease prevention and health promotion
- Preventive Services
- Provider resources - Adult Immunizations
Coverage
Coding
CMS Manuals & Transmittals
- Manuals
- Internet-Only Manuals (IOMs)
- Physician Transmittals
- Transmittals
- Paper-Based Manuals -- Crosswalks from Paper-Based Manuals to Internet-Only Manuals
- To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU Listserv from the CMS Mailing Lists Page.
- National Coverage Determinations (NCD) Manual - Pub. 100-03
Accountable Care Organizations Workshop
- Recordings and Transcripts for the October 5, 2010 Workshop Regarding Accountable Care Organizations, and Implications Regarding Antitrust, Physician Self-Referral, Anti-Kickback, and Civil Monetary Penalty (CMP) Laws (Posted 10/19/10):
- Transcript of Morning / Opening Comments and FTC Panels [PDF, 363KB]
- Transcript of Afternoon / HHS Panel and Listening Session [PDF, 246KB]
Value-Based Purchasing Information
- "Medicare Value-Based Purchasing Program for Physician and Other Professional Services Listening Session" -- December 9, 2008: Transcript [PDF, 482KB] , Agenda [PDF, 20KB] , PowerPoint slides [ZIP, 393KB] Issues Paper [PDF, 211KB] regarding development of a Plan to transition to Medicare Value-Based Purchasing for Physician and Other Health Professional Services. The Plan was mandated by the Medicare Improvements for Patients and Providers Act of 2008.
- - Medicare Program; Plan to Transition to a Medicare Value-Based Purchasing Program for Physician and Other Professional Services: Listening Session, December 9, 2008. Published October 24, 2008.
Forms
Medicare Prescription Drug Coverage
National Provider Identifier
Cost Reporting
Specialty Web Pages
Medicare Secondary Payer
Fraud & Abuse
Specialty Hospitals
Initiatives
- Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
- Physician Compare Initiative
- Physician Quality Reporting System
- EHR Incentive Programs
- Electronic Prescribing (eRx) Incentive Program
- Beneficiary Notices Initiative (BNI)
Contacts
- Physician Regulatory Issues Team (PRIT)
- CMS Regional Offices
- Coordination of Benefits - General Information
How to Stay Informed
- Subscribe now to receive the weekly CMS Medicare FFS Provider e-News for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.
- Physicians, Nurses and Allied Health Professionals Open Door Forum
Media Release Database (includes Press Releases, Fact Sheets, Testimonies, and Speeches)
- Research Reports : A series of reports on the health care industry.
