|
CY 2011 Physician Fee Schedule Proposed Rule The CY 2011 PFS was placed on display at the Federal Register on June 25 , 2010. The proposed rule includes proposed annual updates to the relative weights of physician services and would implement key provisions in the Affordable Care Act of 2010 that expand preventive services for Medicare beneficiaries, improve payments for primary care services, and promote access to health care services in rural areas. The proposed rule is scheduled for publication in the July 13, 2010 Federal Register, and the comment period closes on August 24, 2010. See below to review the proposed rule. CY 2010 Physician Fee Schedule Update On December 19, 2009, the Department of Defense Appropriations Act, 2010 (Pub. L. 111-118) was signed into law. Section 1011 of Pub. L. 111-118 provided a 2‑month zero percent update to the CY 2010 Medicare physician fee schedule (PFS) effective only for dates of service from January 1, 2010 through February 28, 2010. Further, on March 2, 2010, the Temporary Extension Act of 2010 (Pub. L. 111-144) was signed into law. Section 2 of Pub. L. 111-144 extended through March 31, 2010 the zero percent update to the PFS that was in effect for claims with dates of service from January 1, 2010 through February 28, 2010. In addition, on April 15, 2010, the Continuing Extension Act of 2010 (Pub. L. 111-157) was signed into law. Section 4 of Pub. L. 111-157 extended through May 31, 2010 the zero percent update to the PFS that was in effect for claims with dates of services from January 1, 2010 through March 31, 2010. Therefore, for services provided from January 1, 2010 through May 31, 2010, the PFS update remains at zero. Finally, we note that on May 10, 2010, revised payment files for physician claims were released to Medicare Contractors. These revised payment files incorporate changes to payments as a result of the CY 2010 correction notice (on display at the Federal Register on May 5, 2010) and changes resulting from the Patient Protection and Affordable Health Care Act. These changes also result in a change to the conversion factor for claims provided from January 1, 2010 through May 31, 2010. The resulting conversion factor applicable to services provided during this time period is $36.0791. On June 25, 2010, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 was signed into law. Section 101 of Pub. L. 111-192 provides for a 2.2 percent update to the 2010 PFS, effective for dates of service June 1, 2010 through November 30, 2010. The conversion factor for services furnished during this time period is $36.8729. Instructions regarding the reprocessing of claims paid prior to the implementation of these revised files will be forthcoming. Please watch your listserv and contractor's website for more information.
The information that is provided on the physician fee schedule (PFS) web page relates to payment under the PFS and related information concerning the development of the payment amounts. This information is intended for physicians/non-physicians who provide services to Medicare beneficiaries. This information is updated on regular basis when there are payment/policy changes. The formula for calculating 2010 physician fee schedule payment amount is as follows: 2010 Non-Facility Pricing Amount =
[(Work RVU * Work GPCI) +
(Transitioned Non-Facility PE RVU * PE GPCI) +
(MP RVU * MP GPCI)] * Conversion Factor (CF) 2010 Facility Pricing Amount =
[(Work RVU * Work GPCI) +
(Transitioned Facility PE RVU * PE GPCI) +
(MP RVU * MP GPCI)] * CF
The conversion factor for CY 2010 is $36.0846. PHYSICIAN CENTER
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) physicians, go to the Physician Center (see under "Related Links Inside CMS" below).
Page Last Modified: 07/20/2010 7:48:50 AM
Help with File Formats and Plug-Ins
Submit Feedback
|
Email
Print