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2011 conversion factor set at $25.5217, down 30%

CMS finalized the 2011 Medicare Physician Fee Schedule -- and the outlook is not good for your practice next year. The conversion factor used to calculate Medicare payments in 2011 will be $25.5217, down a staggering 30.78% from the current rate of $36.8729.

To give you a quick example of how that impacts you, national payment for 99213, the most commonly billed code, would drop to an estimated $51.81 from the current $66.74, according to the fee schedule.

Today is Election Day, so a lame duck session of Congress will need to do two things - act before Dec. 1 to delay a 23% cut, then again by Jan. 1 to stop an additional 7% cut. Otherwise, your Medicare reimbursements will drop 30% next year. The AMA and other physician associations are lobbying for a temporary payment fix, with the hope that the next Congress will permanently fix the reimbursement formula next year.

Editor's note: The 2011 fee schedule creates brand new challenges for your practice. But you can minimize denials and bring in all the reimbursements due to your practice with the National Part B Billing & Payment Guide. Order this essential Medicare billing guidebook from the DecisionHealth store today.

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