At the last moment, Congress passed legislation to avert the drastic Medicare physician fee schedule reduction that physicians were facing for 2013. The American Taxpayer Relief Act of 2012 includes the following provisions impacting physician reimbursement:
- Prevents the Medicare physician payment Sustainable Growth Rate (SGR) cut for one year. It eliminates the 27 percent Medicare physician payment cut, which was to take effect 1/1/2013 and replaces it with a “zero percent update” to the Conversion Factor (CF) for 2013. It is important to remember that this is not a fee schedule rate freeze because adjustments to RVU’s and other coverage determinations will impact reimbursement rates. It means the conversion factor applied to RVU’s to arrive at the reimbursement rate remains the same and the huge SGR cut is nullified for 2013.
- Postpones the Medicare sequester for two months. This prevents automatic cuts from occurring, including an across the board, two percent cut for all Medicare providers. It’s expected Congress will revisit issues related to the sequester in the near future. If implemented, the sequester will wipe out all gains to the CF that physicians have realized since 2008.
- Extends the Medicare Work RVU floor at 1.0 through December 31, 2013
- Extends the Medicare therapy cap exception process through December 31, 2013
- Increases the Medicare therapy service multiple procedure payment reduction from 25 to 50 percent effective April 1, 2013
View the full text of The American Taxpayer Relief Act of 2012
