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 RESOURCES
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Medicare Physician Fee Schedule Changes for 2009
Passage of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) cancelled an impending 15.1% cut to the 2009 physician fee schedule (PFS) and instead provided a 1.1% increase to the conversion factor. However, MIPPA also changed how the budget neutrality factor is applied to PFS rate calculations in 2009 and this resulted in relatively modest increases and decreases in payments depending upon the service provided. Specifically, MIPPA requires that the budget neutrality adjustor be applied to the conversion factor rather than exclusively to the work Relative Value Units (RVUs), thus spreading the impact across all RVU components. The net effect is that 2009 payment for codes higher in work RVUs (e.g., evaluation and management, physician performed procedures, etc.) will generally increase while those higher in practice expense RVUs (incident-to procedures such as drug administration services) will generally decrease.
Separately payable drugs that are covered under Medicare Part B and administered in the physician practice setting will continue to be reimbursed at a rate of average sales price (ASP) plus 6%.
Each year the CMS recalculates the reimbursement rates for physicians. The
new payment rates are effective January 1, 2009-December 31, 2009.1
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| 1Federal Register, Vol. 73 No. 224, November 19, 2008, Rules and Regulations.
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