Medicare Physician Fee Schedule 2010

The Defense Appropriations Bill (H.R. 3326) signed by President Obama, provides for a 60-day delay in the 21.2% cut in Medicare physician reimbursement scheduled to take effect on January 1, 2010. It is anticipated that the current conversion factor of $36.0666 will be utilized to calculate physician reimbursements during January and February. Other changes published in the final ruling posted November 25, 2009, will be implemented January 1, 2010. These include, but are not limited to, relative value unit (RVU) changes, elimination of consultation codes, and work GPCIs below 1.00.

Many Medicare contractors have already published 2010 physician fee schedules with the planned reduction. In an effort to ensure proper reimbursement with the appropriate fee schedule, CMS instructed carriers to hold all 2010 claims for ten business days (until Jan. 15).

The uncertainty of the fee schedule also extends the Participation Enrollment Program from November 13, 2009 to March 17, 2010. The deadline is typically December 31. Any changes made to your participation status would still be effective January 1, 2010.

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