Medicare Physician Fee Schedule 2011

The Medicare and Medicaid Extenders Act of 2010 (H.R. 4994), signed by President Obama on Wednesday 12/15/2010, provides for a one year reprieve to the originally planned reduction in Medicare physician reimbursement scheduled to take effect on January 1, 2011. It is anticipated that the conversion factor will be similar to the current conversion factor of $36.87. The relative value unit changes (RVU) published in November will most likely be implemented so the fee schedule will not be exactly what your 2010 fee schedule is currently.

The legislation also maintains a floor of 1.00 for work GPCIs and funds reprocessing of underpaid claims from January 2010 through June 2010 as directed by the Patient Protection and Affordable Care Act (PPACA). Revised fee schedules will be added to Medicare contractor websites in the next few weeks.

This does not solve the long-term problem of the sustainable growth rate (SGR) formula which is the crux of the fee schedule dilemma. We will wait to see if Congress attempts to tackle the issue in 2011.

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