Handful of fee schedule changes effective April 1
August 5th, 2014 - Scott KraftThe combination of the passage of the Protecting Access to Medicare Act of 2014 and some tweaks to relative value units paid under the physician fee schedule means there were a handful of changes made to the fee schedule for the second quarter. These changes are retroactive to Jan. 1, but Medicare Administrative Contractors (MACs) had until April 7 for implementation.
The changes are documented in transmittal 2923 to the Medicare Claims Processing Manual.
The biggest changes are really not changes at all. The law froze the conversion factor at $35.8228 through the end of the year, heading off what would have been a 24 percent payment cut. The law also holds a minimum 1.0 work GPCI floor for the rest of the year.
Here are some of the other tweaks made to the fee schedule:
- The short descriptors for G0416-G0419 were revised. The new descriptors are G0416, biopsy prostate 10-20 spc; G0417, biopsy prostate 21-40; G0418, biopsy prostate 41-60 and G0419, biopsy prostate, greater than 60.
- RVUs were boosted for respirator motion management simulation code 77293, which will result in a payment increase for the service.
- G9361 for there being a medical reason for early induction of a pregnancy was added to the fee schedule, but with a non-payable status indicator of M.
- The level of physician supervision was corrected for the technical component of a number of imaging codes. The following codes should have an indicator of 01 (general supervision): 70551-TC, 72141-TC, 72146-TC, 72148-TC, 93880-TC and 93882-TC. These codes should have an indicator of 02 (direct supervision): 70460-TC, 70552-TC, 70553-TC, 72142-TC, 72147-TC, 72149-TC, 72156-TC, 72157-TC, 72158-TC, 72191-TC, 74174-TC and 74175-TC. These codes have an indicator of 03 (personal supervision): 77001-TC, 77002-TC and 77003-TC.
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