Practice expense (PE) and malpractice relative value unit (RVU) updates will increase the total RVUs for high-utilization services that you and your peers bill in 2011, a Part B News analysis of the 2011 Medicare Physician Fee Schedule shows. The increases helped soften projected Medicare payment cuts, but are not enough to prevent decreases across the board.

The Republican wave of Congressmen who won seats on Election Day added new health care professionals to lawmaker ranks. You may want to seek them out when lobbying for health care issues, such as the Medicare reimbursement issues. There will be three physicians in the Senate and 16 in the House starting in January - all Republicans except one. 

Your chances of seeing an automatic bonus payment worth 10% of your Medicare allowed charges for primary care services in 2011 have nearly doubled, thanks to major changes made by CMS in its final 2011 Physician Fee Schedule (PFS).

You still have time to enroll your physicians and other providers in its Provider Enrollment Chain and Ownership System (PECOS) before the ordering/referring deadline on Jan. 3. However, you may end up getting even more time in 2011. CMS has not yet decided when it will turn on claims processing edits that will make sure the ordering/referring provider listed on a claim is in PECOS.

Democrats and Republicans are united in wanting to pass a temporary pay fix before your payments take a 23% nosedive Dec. 1. Neither side was willing to offer specifics such as how long the fix would last or when it would pass, but agreed the election rout of the Democrats doesn't change the need to fix your payments. But in separate interviews with Part B News, members of each party shared sharply opposite views on the idea of repealing the health reform law.

You must use your claims to report at least 10 eligible electronic prescribing (e-prescribing) encounters during the first six months of 2011 or your payments will be reduced by 1% in 2012. Claims-based reporting is the only method you can choose to report G8553 and prevent the 2012 penalty. You can still use other reporting methods, but those options won't keep CMS from lowering your payments.

Does Medicare allow a physician to order X-rays before seeing a patient? This happens commonly when the patient is referred to our orthopedic practice from a primary care or urgent care center for a suspected fracture, and no films have been taken.

You'll only need to furnish patients with a list of five alternative suppliers within a 25-mile radius for advanced imaging services you furnish in your office in order to comply with the new disclosure requirements finalized by CMS in the 2011 Physician Fee Schedule Final Rule. The agency initially wanted you to list a minimum of 10 (PBN 7/5/10).

Denial rates for most specialties don't change significantly depending on whether their services were rendered in the office or outpatient hospital setting. This chart shows how specialty-specific denial rates compare to the average or baseline denial rates for the office and outpatient hospital settings in 2008 and 2009.

Last week, we told you about high deductible health plans (HDHPs) and how they put your practice at risk for potentially being stuck trying to collect high patient balances after you've already provided the services(PBN 11/1/10). If you haven't dealt with HDHPs yet, you will soon. Here are eight tips to make sure you get the money you deserve for providing the services.