Medicare Fee Schedule Update 2004
On January 7, 2004, the Centers for Medicare and Medicaid Services (CMS), published in the Federal Register the 2004 Medicare Physician Fee Schedule. The conversion factor used to calculate Medicare payments will increase in 2004 by 1.5 percent. The November 7, 2003 final rule had previously stated that the physician fee schedule would decrease by 4.5% however, with the recent passing of the Medicare Improvement, and Modernization Act of 2003, there is a requirement that the physician fee schedule updates must be at least an increase of 1.5%. The physician fee conversion factor for 2004 has increased to $37.3374 from $36.7856 in 2003. Along with the increase in conversion factor, work Geographic Practice Cost Indices (GPCI) rates in every state must now be at least 1.0. The work GPCI in Alaska has also been increased to 1.67. These changes in work GPCI rates will only affect those in states which previously had a work GPCI of less that 1.0 and individuals in Alaska.
The following are the Medicare reimbursement rates for chiropractic manipulation as established under the 2004 Medicare fee schedule for Alabama. Alabama previously had a work GPCI of 0.9878 and therefore was affected by both the change in the fee schedule and the change is work GPCI requirements.
FY 2003
FY 2004
98940 $24.16
98940 $24.88
98941 $33.58
98941 $34.59
98942 $44.03
98942 $45.34
For a complete listing of state-by-state GPCI rates please refer to your 2004 ACA Coding Solutions Manual or you may access the January 7 edition of the Federal Register online at http://www.gpoaccess.gov/fr/index.html . For assistance in determining your state specific reimbursement rates please contact your local Medicare carrier. If you would like to purchase the 2004 edition of the Coding Solutions Manual please call 800.368.3083.
