2019 Proposed Medicare Physician Fee Schedule Released: Shows Cuts Across the Board to Professional Fees; Raises to Most Technical Component Charges

In early July, The Centers for Medicare and Medicaid Services (CMS) released its proposed Physician Fee Schedule (PFS) for 2018.  This proposal included revaluation of Practice Expense RVUs on both the Professional and Technical Components.  As a result, the TC stands to increase for most Pathology CPTs, with the exception of Non-Gyn Cytology codes and Flow Cytometry that are currently projected to have decreased reimbursement on both the Professional and Technical Components. 

Professional Component Charges are projected to be cut across the board, with very few exceptions.  Overall, Pathology is expected to see a 1% decrease in allowed charges by Medicare compared to the 2018 PFS.  Groups billing professional component services only should expect to see around a 2% overall decrease in Medicare revenue, if the proposed PFS is finalized.  All items in the Medicare proposed PFS are open for public comment by September 10, 2018.

APS will continue to monitor the 2019 PFS as it advances from proposal to final rule.  Be on the lookout for our White Paper this fall, which will outline all PFS changes that effect your revenue.  If you have any questions, please contact your Practice Manager.