Part B News

by: Charles Fiegl Jan 10, 2011

CMS has gone through an expedited rule making process to remove the voluntary end-of-life care provision from annual wellness visits (AWV). Part B News subscribers can read our full coverage of this story, but here is CMS's full explanation for why it is scrubbing end-of-life care from the services.

"... we published the proposed rule entitled 'Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011.' In response to this publication, we received comments from health care providers, and others urging us to add voluntary advance care planning as a specified element of the definitions of both the 'first annual wellness visit' and the 'subsequent annual wellness visit.' The commenters stated that their recommendations were based upon a number of recent research studies, and the inclusion by the Medicare initial preventive physical examination (IPPE) provisions of a similar element in the existing IPPE benefit.

CMS updates price for 90656 on ASP list

by: Charles Fiegl Jan 6, 2011

CMS has revised its price for 90656 (Flu vaccine no preserv 3 & >). The code will now pay $12.375, which is the same amount paid during the code during the fourth quarter in 2010. An earlier version of CMS's average sales price (ASP) plus 6% payment system listed the price at $14.001.

Report: White House cuts end-of-life plan from AWV

by: Charles Fiegl Jan 5, 2011

A New York Times report says the Obama administration is removing the end-of-life care planning component to the new annual wellness visit (AWV) service.

The end-of-life plan, which is voluntary and requires patient consent, is just one of several parts to the service. The planning was added in the finalized 2011 Medicare Physician Fee Schedule, but it was not included in the proposed rule released in July.

Robert Gibbs, the White House press secretary, said on Wednesday that this prevented the public from commenting on the provision during the rulemaking process.

CMS and HHS would not comment on the report Wednesday morning. Also, CMS had not issued any guidance on removing the component to the service.

Annual wellness visit patient encounter form

by: Charles Fiegl Jan 4, 2011

Are you providing the annual wellness visit in 2011? If so, try using our initial annual wellness visit (AWV) patient encounter form. The AWV form was featured as Part B News' Tool of the Month in November. All Part B News subscribers have access to these tools for free and subscribers have permission to download the form and use it at their practice.

Subscribers can download the file by going to the Tool of the Month article for November and clicking on the "Download File" link.

2011 conversion factor goes down, pay goes up?

by: Charles Fiegl Jan 3, 2011

CMS released an updated 2011 conversion factor just days before the New Year, as the last 2010 Part B News newsletter was going to press. This left us with little time and space to write much detail about how the new conversion factor, $33.9764, will impact physician payments.

The conversion factor is just one component of the Medicare payment formula. So, you shouldn't be surprised that some payments, in particular E/M codes, increased in pay despite the 2011 conversion factor dropping 7% from the 2010 rate of $36.8729.

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