Information on Medicare Claims and Payments for January 2013

While Congress’ action to avert the fiscal cliff at the ninth hour is good news, the decision may have a slight impact on Medicare claims and payments. Palmetto GBA posted this useful article that provides some useful, early guidance. A few quick highlights:

  • The 26.5 percent SGR cut that was scheduled to take effect on January 1, 2013 has been put off through December 31, 2013. 
  • The 2013 conversion factor is $34.0230
  • CMS has authorized Palmetto GBA to hold claims for up to 10 business days while they load and test the revised fee schedule.  (Palmetto does not believe it will need to hold claims this long.)
  • Palmetto GBA must post the revised fee schedule on their website by January 23, 2013.
  • Physicians who want to change their participation status with Medicare have until February 15, 2013 now. (Previous deadline was December 31, 2012.)

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