Your payments for reading and interpreting the results of diagnostic MRIs, CTs and ultrasounds are under siege by a major new provision in CMS’s proposed 2012 Medicare Physician Fee Schedule (PFS), an exclusive Part B News analysis shows. Under the proposal, the professional component (PC) of affected diagnostic imaging tests would be paid in full once for the most valuable CPT code, then paid at 50% of the fee schedule rate for the second and all subsequent codes.

Does the type of service you bill have any connection to your likelihood of getting an accurate payment from a private plan? How does the accuracy of private plans compare to Medicare, by service type? The charts this week dive deeper into the private payer vs. Medicare comparison.

One of our physicians unexpectedly resigned from our group practice. We obtained written permission from the doctor to use his national provider identifier (NPI) to bill for the services of a locum tenens doctor. We know locum tenens rules set a limit of 60 calendar days to bill for services under the regular/resigning physician and the clock starts to tick from the first day the locum sees a patient.

This table shows the projected payment impact of proposed relative value unit (RVU) changes by specialty, based on CMS's 2012 Physician Fee Schedule proposed rule.

Review this complete list of 119 codes that would be affected by CMS's proposed expansion of its multiple procedure payment reduction (MPPR) rule. The MPPR currently affects the technical component (TC) of these 119 codes, but CMS wants the MPPR to hit the professional component (PC) of these codes as well. This provision is being proposed in the 2012 Physician Fee Schedule proposed rule.

Your payments for test interpretations could be cut in half the same way as the technical component is for advanced diagnostic imaging – a proposal that stands out in the proposed 2012 Medicare Physician Fee Schedule, released July 1. The expansion of the multiple procedure payment reduction is just one of many changes CMS wants to implement in 2012. Read up on the highlights in our initial coverage.

You can only hope that CMS will finalize its recent proposed rule that creates new e-prescribing hardship exemptions, now that the June 30 deadline to e-prescribe for at least 10 unique patients has come and gone. Many practices say they would qualify under one of the proposed exemptions, but the certainty of those exemptions being finalized is shaky.

CMS unveiled a new concerted ad campaign aimed to encourage more seniors to take advantage of health reform’s free preventive services through Medicare and Medicare Advantage, in a news conference June 20. But it is unclear whether private payers will extend such services to patients with older policies free of charge.

Your physicians must each meet 20 meaningful use measures to collect their $18,000 checks from Medicare’s Electronic Health Record (EHR) Incentive Program, but many measures may be easier in practice than theory. That’s the consensus from doctors who have adopted EHRs, met meaningful use and cashed their government incentive checks.