Medicare Fee Schedule Changes

Bob Hall, our federal government relations lobbyist manager and health policy advocate, provided a detailed update on pending changes to Medicare payments. Here are the key points:

1. Medicare Fee Schedule Cut: The upcoming fee schedule, expected around July 4th, includes a projected 2.93% cut due to existing statutes. This cut can potentially be mitigated through federal advocacy, a strategy that has been successful in previous years. It’s crucial to engage with Congress to address this issue.
2. Impact Beyond Medicare: The cut is not limited to Medicare alone. Many private contracts are based on a percentage of Medicare rates, meaning a cut in Medicare payments will also affect private pay rates. This ripple effect could extend to Medicaid, CHIP, and other programs.
3. Telehealth Services: The continuation of telehealth services is under consideration. While telehealth offers flexibility and high-quality care, it also increases costs due to higher service utilization. This aspect will be closely examined by both Congress and CMS.
4. Revaluation of CPT Codes: Changes to the valuation of certain CPT codes are expected. These adjustments will be made by the AMA’s Relative Value Scale Update Committee (RUC) and subsequently reviewed by CMS. It’s essential to stay informed as these changes could impact your reimbursement rates.

Timeline

• Draft Fee Schedule: Expected around July 4th
• Final Fee Schedule: Anticipated around November 1st

To stay updated on these and other important issues, please subscribe to our AOPT. Your involvement and advocacy are vital in ensuring that our voices are heard and that we can continue providing high-quality care to our patients.