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.
San Francisco, CA