Update: On December 22, 2009, President Obama signed a bill into law which contained a provision to put a hold on the fee cut. Congress wanted and needed more time to figure out the best course of action.

For now, consider your fees frozen. There are a few exceptions, such as consultation codes 99241-99245 and 99251-99255 which are no longer payable under Medicare Part B. Individual carriers may have other exceptions so visit their websites or contact their provider relations department.

December 1, 2009

Unless there is Congressional intervention, effective January 1, 2010, the Medicare fee schedule (also known as the physician fee schedule) will include a 21.2% fee cut. Such a drastic change is the result of nearly 10 years of delayed mandated cost cuts. The Final Rule published in the Federal Register on November 25, 2009 "announces that the update to the physician fee schedule conversion factor is -21.2 percent for CY 2010".

Professional organizations and advocacy groups have attempted to block this fee cut. Legislation (H.R. 3961) introduced Oct. 29 by Rep. John Dingell (D-Mich.) actually proposes a change in HOW the payment rates are calculated. It proposed "to amend title XVIII of the Social Security Act to reform the Medicare SGR payment system for physicians." The flawed Medicare SGR payment system is the root cause of the last minute fee adjustments over the last several years.

On November 6, 2009, the House met to discuss this as an Emergency item. It passed the House and on 11/20/2009 it was received in the Senate. Click here to read details about this recently passed bill. Another good article is found HERE.

IF this passes the Senate, it is likely that instead of a 21% rate cut, there could be a 1.2% fee increase which is based on the Medicare Economic Index (MEI) for 2010 (this can be found in the Federal Register table 33). However, it should be noted that earlier this year a similar bill in the Senate was blocked and right now they are pretty busy with the Health Reform bill.

As of today, plan for a 21% pay cut. If any changes are made to avert the pay cut, InstaCode Institute will update our products with these changes as they become available.