Medicare Physician Fee Schedule

Overview

On October 31, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies and rates for services furnished under the Medicare physician fee schedule beginning January 1, 2015. In an AAFP statement released after the final rule became available, the AAFP expressed “disappointed that, once again, current law requires CMS to slash Medicare physician payment by 21.2 percent on April 1, 2015. Without Congressional action to permanently repeal the sustainable growth rate formula that requires this devastating cut, Medicare patients will continue to struggle with insecure access to health care.” The current Medicare conversion factor through March 31, 2015 is $35.8013. Unless Congress intervenes, starting on April 1, 2015, the conversion factor will be $28.2239.

AAFP Perspective

The American Academy of Family Physicians is extremely disappointed that, once again, current law requires CMS to slash Medicare physician payment by 21.2 percent on April 1. Without Congressional action to permanently repeal the sustainable growth rate formula that requires this devastating cut, Medicare patients will continue to struggle with insecure access to health care.

Family physicians applaud the planned payment of a new chronic care management code, because it is a step toward recognizing the value of the often complicated clinical oversight that – although needed by many Medicare beneficiaries – requires significant clinical time outside the exam room. As a result of implementing payment for this code, elderly and disabled patients will have better access to the care they need to reduce and avoid complications of their conditions and expenses that come with treating such complications. The AAFP will monitor the documentation requirements related to these codes to ensure they are not overly burdensome for practicing physicians. 


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