November 02, 2012
Yesterday the Centers for Medicare & Medicaid Services (CMS) released the final 2013 Medicare Physician Fee Schedule announcing payment rates for the services we and other doctors provide to Medicare beneficiaries. In the bullets below, we discuss several of the key decisions relevant to the practice of Interventional Cardiology, but the over-riding message we wish to share with you, SCAI’s members, is this: In an overt effort to transfer funds from the payment of specialty procedures to primary care, CMS has targeted established procedures for bundling and revaluation, with the assumption that bundled services include economies and support lower values. CMS has increasingly ignored the coding and valuation recommendations developed through the AMA’s CPT and RUC processes. Now, in an unprecedented move, CMS is rejecting many of the new codes developed for PCI and announcing 19%-28% reductions in the base codes for stenting procedures. We are closely examining the calculations CMS made to ensure no errors were introduced and that related practice expense and malpractice values were captured with the bundled codes.