Medicare Physician Fee Schedule 2009

The Medicare Physician Fee Schedule released October 30, 2008, includes a conversion factor of $36.0666. This is lower than the 2008 conversion factor of $38.0870.

The Medicare Improvements for Patient and Providers Act (MIPPA) of 2008 included a provision for a 1.1% update to the conversion factor. The reason the conversion factor is lower for 2009 is that the budget neutrality adjustor that had been applied to a portion of the fee schedule calculation for the past two years was discontinued. The adjustment shifted to the conversion factor, resulting in a lower number.

Overall, ophthalmology realizes a 1% increase in reimbursements. Here are some examples of the changes in reimbursement from 2008 to 2009.

  • Eye Exam (92014) 1%
  • Eye Exam (92012) 1%
  • E/M Level 3 (99213) 3%
  • SCODI (92135) -1%
  • SLT (65855) -1%
  • Cataract surgery w/IOL (66984) 2%
  • YAG capsulotomy (66821) 0%

Other highlights include:

  • Two new codes for endothelial keratoplasty
  • Updated PQRI information, with three new PQRI measures for ophthalmology
  • Updated information for E-Prescribing bonus

Deferral of a proposal that would have required the quality and performance standards mandated in independent testing facilities to be required for physician practices

The Federal Register publication date is planned for November 15, 2008.

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