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Medicare Releases Final 2011 Conversion Factor for Physician Fee Schedule
Final Conversion Factor will Result in a Reduction in Fees for Emergency Medicine Services
PINECREST, FL, January 3, 2011 - On December 29th, 2010, CMS released Transmittal 828 of the CMS Manual System. Amongst other items, this transmittal instructed Medicare carriers and intermediaries to use a conversion factor of 33.9764 when calculating the 2011 physician fee schedule. The 2010 conversion factor was 36.8764. The stated reason for this 7.9% reduction in the conversion factor is to maintain budget neutrality based on increased practice expense RVUs that were a result of the congressionally-mandated Medical Economics Index (MEI) rebasing exercise.
For emergency medicine, the combination of the 7.9% conversion factor reduction and moderate increases in practice expense and malpractice RVUs will lead to a two to three percent reduction in fees for emergency services evaluation and management codes.
Dr. Jeffrey Bettinger, Managing Member of BSA Healthcare said of the conversion factor reduction, "There is a fair amount of confusion in the physician community regarding the Medicare conversion factor. Many physicians assumed that the one-year SGR stopgap recently passed by Congress would lead to no reduction in the 2011 Medicare conversion factor. Because the MEI rebasing exercise led to across-the-board increases in practice expense RVUs, CMS was obligated to reduce the 2011 conversion factor to maintain budget neutrality. Some specialties - especially those with high practice expense RVUs - stand to gain from the new conversion factor. Those specialties that will not fare so well - including Emergency Medicine - tend to have lower proportional practice expense RVUs when compared to work RVUs."
BSA Healthcare helps emergency medicine groups maximize their revenue in a compliant fashion. For more information on the SGR reduction formula, or BSA Healthcare's services, please call Jeffrey Bettinger, M.D., FACEP at 305-860-3098, or email Dr. Bettinger at jbettinger@bsanda.com.
About Bettinger, Stimler, Schultz & Associates
Bettinger, Stimler, Schultz & Associates (BSA Healthcare) is a physician-owned healthcare consulting firm that helps hospitals, academic medical centers, private medical practices, and outpatient facilities improve quality, financial performance, operations, organizational structure, and strategic direction.
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