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News
The 2008 Medicare Physician Fee Schedule was finalized by Congress in late December, 2007. CMS previously called for a 10% across the board cut to the 2008 MPFS and, after several earlier attempts by Congress, an agreement was reached to block the cut and provide for a 0.5% increase. Since doctors of chiropractic were facing a 12% cut, the net result is a 1.5% decrease to the chiropractic fee schedule under Medicare. The legislation that was passed addressed the cuts for a period of six months. Congress revisited the issue in July 2008, continuing the fee schedule at its current levels through the end of 2008 and providing a 1.1% positive update for 2009.
To view HR 6331, the Medicare Improvement for Patients and Providers Act of 2008, click here.
ACA lobbied Congress and joined a number of medical specialty groups to oppose the cuts to the fee schedule. We will continue to monitor the Congressional proceedings surrounding this issue to make the concerns of the ACA known.
Note: Because the fee schedule formula includes many different factors, including a geographic consideration, the most accurate information on fee schedule prices in your area will come from your individual Medicare carrier/contractor. If you are uncertain as to whether or not your carrier’s website is up to date, you may wish to call them directly. To find contact information for your local carrier, visit the CMS Intermediary-Carrier Directory (most DCs will be interested in “Part B” information). You can also check out our Resources and Q&A sections for more information.
The cut that would have come to some providers was a result of CMS' Congressionally-mandated 5-yr-review of CPT codes. This process, and its resulting final rule, produced significant increases in reimbursement to higher level E/M codes. To keep the proposal budget neutral, an adjuster was applied which hit several professions particularly hard. As a result of this, CMT codes were scheduled to take a 12% cut.
ACA thanks all DCs for pressuring Congress to act on cuts to the fee schedule. Although DCs will still took an average 1.5% reduction in 2008, a drastic cut was avoided. ACA will continue to urge Congress for action on physician fee schedule reform. We encourage members to continue to use our Legislative Action Center to promote reform to the reimbursement formula.
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Resources
To access the most accurate information for your region, we recommend consulting with your local Medicare carrier. Your carrier website will likely have an educational section on the physician fee schedule, as well as information on how to order a print version of it. (CMS’ Carrier Directory allows you to select your state and identify your carrier. [DC’s will likely be most interested in the Part B information.])
Some Examples:
Links:
For more information on the fee schedule, including a detailed explanation of participating versus non-participating billing, please visit our Q&As.
Historical Fee Schedule Info:
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