The Centers for Medicare and Medicaid Services (CMS) has released the proposed physician payment rule, which confirms that, unless Congress intervenes, Medicare’s physician payment will fall by 29.5% in 2012.
In the rule CMS suggests solidifying annual review of CPT code values, which would replace the 5-year reviews used previously to identify any potentially misvalued codes. This will continue to place a burden on the specialty societies involved in the process, to continuously review and survey codes. In addition, CMS is rejecting recommendations made by the RUC for a number of codes related to interventional spine procedures such as epidural lysis, and neurostimulator related codes; and demands that code 62311 (Injection, Spine L/S, Caudal) be reviewed within the next year.
CMS also outlines decisions related to Physician Quality Reporting System (PQRS) and the electronic prescribing (eRx) and electronic health records (EHR) incentive programs.
The complete rule is available at http://www.gpo.gov/fdsys/pkg/FR-2011-07-19/pdf/2011-16972.pdf. Comments on the proposed rule are due August 30 and the final 2012 payment rule is expected to be released in November 2011.