Notes
1.Update adjustment factor.
2.Reflects the growth in the MEI, the update adjustment, and legislation that impacts the physician fee schedule update. The legislative impact is ?0.2percent in 2001-2003. For 2004 and 2005, the Medicare Modernization Act of 2003 established a minimum update of 1.5percent. For 2006, the Deficit Reduction Act of 2005 froze the physician fee schedule conversion factor. The conversion factor freeze, along with refinements to the relative value units, results in an update of 0.2percent for 2006. The conversion factor was frozen again for 2007 by the Tax Relief and Health Care Act of 2006. The Medicare, Medicaid, and SCHIP Extension Act of 2007, together with the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, specified an update of 0.5percent for 2008. MIPPA also specified an update of 1.1percent for 2009. The Department of Defense Appropriations Act of 2009, the Temporary Extension Act of 2010, and the Continuing Extension Act of 2010 established a 0.0-percent update for January to May 2010. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, and the Physician Payment and Therapy Relief Act of 2010, established a 2.2 percent update for June to December 2010. The Medicare and Medicaid Extenders Act of 2010 specified an update of 0 percent for 2011. The Temporary Payroll Tax Cut Continuation Act of 2011 and the Middle Class Tax Relief and Job Creation Act of 2012, established a 0 percent update for 2012.
3.Reflects the growth in the MEI, the update adjustment, and all legislation affecting physician services--for example, the addition of new preventative services enacted in 1997, 2000, and 2010. The legislative impacts would include those listed in footnote 2.
4.Equals combined increases in allowed fees and residual factors.
A physician payment price change occurred on March1,2003 and on June 1,2010.

