In a bi-partisan vote January 1, 2013 the House of Representatives voted 257-167 in favor of the Fiscal Cliff legislation. The approved plan maintains tax cuts for individuals earning less than $400,000 and couples earning less than $450,000 and raises taxes that make more. The legislation also directly impacts reimbursement.
The SGR cut of 26.5% is rescinded and the Conversion Factor for the physician fee schedule will be frozen for 1 year. Due to the timing of this ACT, computer systems have to be revised by Medicare to accommodate the change. CMS announced that Medicare may hold MPFS claims with January 2013 dates of service for up to 10 days, to allow time to develop, test and implement the revised payment rates. Medicare expects these claims to be processed no later than 1/16/2013.
This delay provides temporary relief to physicians across all specialties. As with the previous handful of years, Congress is seeking a “fix” to the SGR by year’s end. APS will keep you up to date as this issue continues to unfold. If you have any questions in the meantime, please contact your Account Manager.
"APS performed a comprehensive Coding Audit Review and subsequent financial impact assessment resulting in a significant increase in our revenue."