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Emergency Medicine RVUs Decrease in CMS Proposed Rule for the 2012 Medicare Physician Fee Schedule
PINECREST, FL, July 12, 2011 - On July 1st, 2011, CMS released the proposed rule for the 2012 Medicare physician fee schedule. Overall, CMS estimates that Emergency Medicine will undergo a 1% reduction in payments for 2012, assuming that the massive 2012 SGR-related conversion factor reduction is avoided.
SGR-related Overall Payment Reduction: As in past years, Medicare Part B expenses have exceeded SGR targets, leading CMS to publish a formulaic reduction in the conversion factor used in the physician fee schedule. Unless altered by Congress, the conversion factor will decrease by 29.5% in 2012. In recent years, Congress has provided short-term fixes to the SGR-related fee schedule reductions. It remains to be seen whether Congress will once again delay the scheduled fee reduction.
Many other elements related to emergency medicine reimbursement, including implementation of PPACA regulations are included in the proposed rule. Additionally, CMS has proposed re-evaluation of RVUs for many evaluation and management services, including those for emergency services (CPT Codes 99281 through 99291). For most emergency medicine practices, these codes comprise 80% to 90% of gross charges and net revenue. The complete rule is available online at http://www.federalregister.gov/inspection.aspx#special
Dr. Jeffrey Bettinger of BSA Healthcare will present a 1-hour webinar on July 25th at 1pm EDT to review the proposed rule and discuss what actions emergency physician groups should be considering in order to prepare for the upcoming Medicare and PPACA changes. To register for the webinar, please call 561-434-4740, or visit the Upcoming Webinars section of the BSA Healthcare home page at www.bsahealthcare.com.
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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