Medicare Physician Reimbursement Cut Still Looms

The Centers for Medicare and Medicaid Services (CMS) is currently developing the 2012 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update that was included in the Temporary Payroll Tax Cut Act signed by President Obama on December 23, 2011. As previously announced, Medicare claims administration contractors will hold new January 2012 claims for up to 10 business days in order to effectively test and implement the new 2012 MPFS. CMS expects these claims to be released into processing no later than January 18, 2012. Claims with dates of service prior to January 1, 2012, are not affected. NC Medicare contractor Palmetto GBA will be posting new rates on its website no later than January 11, 2012.

NCMS President Robert W. Monteiro, MD, addressed the need to fix the SGR in a letter that was published in the New Bern Sun-Journal on December, 27, 2011. The NCMS and the AMA support a proposal that would leave Medicare physician reimbursement at current levels for two years, giving Congress time to repeal the SGR and develop a plan that would establish a reimbursement structure that meets the actual costs of physician services. Under the SGR, the gap between physician costs and Medicare reimbursement has grown dramatically wider over the past ten years, putting the cost of reforming the SGR at $298 billion at the end of 2011. The AMA projects the costs will grow to $320 billion if Congress fails to act in 2012.


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1 Comment

  • Robert Appel, MD

    If the feds are going to withhold our payments until 1/18, then I believe we should hold the payment of our payroll taxes until then. Turnabout is fair play.