CMS Medicare Physician Fee Schedule Could Benefit Docs

However, proposed implementation of sustainable growth rate formula threatens primary care

TUESDAY, July 16 (HealthDay News) -- The Centers for Medicare and Medicaid Services has released the 2014 proposed Medicare physician fee schedule, which could help create a more equitable payment system by adjusting misvalued codes and proposing new complex management codes, according to a report published by American Academy of Family Physicians.

The proposals for adjusting misvalued codes could result in an estimated 1 percent overall payment increase for family physicians as a result of an up to 3 percent increase in payment rates for evaluation and management services.

However, the sustainable growth rate (SGR) formula, which calls for a 24.4 percent reduction in the Medicare physician payment rate on Jan. 1, 2014, threatens any increase for primary care. If enacted, the SGR reduction would cost an average family physician $89,763 in revenues. Congress has been urged to pass a bipartisan bill repealing the SGR and to establish mechanisms to better reward primary care and encourage innovative payment models.

"If Congress fails to avert this disastrous pay cut before 2014, family physicians once again will be forced to choose between caring for Medicare beneficiaries at a significant financial loss or ending their participation in Medicare," said Jeff Cain, M.D., president of the American Academy of Family Physicians, according to their news story. "No small business can sustain itself in the face of such drastic revenue reductions."

More Information

Physician’s Briefing Staff

Physician’s Briefing Staff

Published on July 16, 2013

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