American College of Physicians: Internal Medicine — Doctors for Adults ®


New Medicare fee schedule: mixed news and confusion

Delays in publication give physicians more time to fight the cuts and to opt out of the program

From the February ACP-ASIM Observer, copyright 2003 by the American College of Physicians-American Society of Internal Medicine.

The CMS' publication of the Medicare fee schedule in late December produced good news, bad news and confusion about deadlines for physicians to change their participation status in Medicare.

Here is an overview of the new fee schedule's immediate impact on internists:

  • Medicare cuts. First, the bad news: The CMS kept the 4.4% cut to physician reimbursement in the fee schedule. The good news was that the CMS announced that the cuts would be delayed until March 1, giving the College and other medical organizations more time to pressure Congress to restore physician fees.

    Other hopeful news arose at press time. The Senate was expected to pass an omnibus fiscal year 2003 budget appropriations bill that would postpone the 4.4% cut until October 1, 2003, giving Congress more time to enact a long-term solution. Earlier, Rep. Bill Thomas (R-Calif.), chair of the House Ways and Means Committee, introduced a bill that would block the new fee schedule from taking effect. At press time, the House had not ratified the proposal.

    ACP-ASIM officials urged internists and their patients to take advantage of the delayed fee schedule implementation by contacting their legislators. Intense grassroots lobbying last year by the College and many other medical organizations helped convince many members of Congress to support physicians, but no legislation was passed.

    To help physicians continue to fight the fee cuts, the College updated its online Medicare Crisis Action Kit, which includes advice on how to influence Congress to enact necessary legislation to restore physician reimbursement. The Medicare Crisis Action Kit for both physicians and patients is available online.

    The College is also urging members to take part in an online survey about their 2003 Medicare participation status. Results will help the College's efforts to avert Medicare fee cuts. The ACP-ASIM Medicare Crisis Action Kit Survey is available online.

  • Immunization fees. The new Medicare fee schedule gave physicians some good news in the form of improved immunization rates. Medicare has nearly doubled its rates for administering vaccines for influenza, pneumonia and hepatitis B. The College had strongly recommended that the CMS improve its vaccination fees to encourage more physicians to immunize patients against influenza and other conditions.

    The CMS also used the new fee schedule to announce changes to the Medicare economic index to increase the funds available for physician reimbursement.

  • New deadline to opt out of Medicare. The delayed publication of the fee schedule created some confusion about the deadline for physicians who want to opt out of Medicare or change their status in the program.

    Because of the delay, the CMS gave physicians until Feb. 28 to change their participation status for 2003. Many physicians, however, received letters in January telling them the deadline was Dec. 31 of last year.

    The CMS sent a memo to Medicare carriers in January telling them about the extended deadline. Many carriers, however, had already sent out letters telling physicians about the Dec. 31 deadline.

For more information on the deadlines for changing your participation status, as well as a guide to how changing your status would affect you, go to ACP-ASIM Online.

For more information on how the new fee schedule will affect your coding and billing, see, "CPT changes codes for patient transport, labs and call."


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