CMS Releases Proposed Rule on 2014 Medicare Physician Fee Schedule

The proposed rule for the Medicare Physician Fee Schedule for Calendar Year 2014 was released on July 8th by the Centers for Medicare and Medicaid Services (CMS). The proposed rule states that the 2014 conversion factor will be reduced by 24.4% due to the statutory Sustainable Growth Rate (SGR) formula, unless Congress intervenes. Additionally, one of the many provisions in the proposed rule is the adoption of the recommendations from the AMA’s Relative Value Scale Update Committee (RUC), changing the current practice expense inputs for CPT code 76942 (ultrasound guidance for needle placement). If retained in the final rule, these changes could reduce the national average payment for CPT code 76942 by approximately 70%, even with the assumption that Congress intervenes and freezes the current conversion factor. CMS also proposes to establish two new codes to pay for complex chronic care management (when a patient has two or more chronic conditions). However, the proposed scope of services for these codes is very extensive and may preclude most endocrinologists from being able to bill for them.

AACE is currently reviewing the rule for comment and will continue to provide further details as they become available. For more information and to review The Federal Register notice, click here.

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