More Cuts Looming from CMS

As discussed in this newsletter, the technical component (TC) of CPT 88305 was cut by 52% for calendar year 2013, along with multiple other surgical codes. Still looming are 4 additional factors that will effect reimbursement next year, dependent on Acts of Congress and final rulings by CMS. These factors are:

1. CPT Code specific adjustments due to formula changes in the physician work component assigned to those codes could increase or decrease.
2. SGR related adjustment of negative 26.5%.
3. GPCI Floor could fall below 1, negatively impacting 2013 reimbursement.
4. Sequestration related adjustment of negative 2%.

Each of these are set to take place on or around January 1, 2013. APS has produced a white paper on this topic, which further outlines these payment affecting factors.  To read the complete white paper, please contact your Account Representative or visit our website at www.apsmedbill.com.