New 2012 Medicare Fee-for-Service Payment Rates Effective January January 6, 2012 Medicare, News, Payment Geographic Practice Cost Index, Medicare, Resource Based Relative Value System 0 Physicians should expect some changes in their payment rates. Numerous changes were made to the relative value units, geographic practice cost indexes, and multiple procedure payment rules for 2012. Changes to electronic prescribing reporting and quality reporting programs will also be implemented. All of these changes will take effect for dates of service beginning January 1, 2012. 0.18 percent increase in the conversion factor: In addition, although PL112-078 provided for a 0 percent update to the Medicare conversion factor for January and February 2012, the final CMS rule indicated that there would be a 0.18 percent increase in the conversion factor for budget neutrality, and that this change will also be effective January 1, 2012. The budget neutrality increase is due to CMS adoption of the relative value system (RVS) Update Committee recommendations for misvalued codes. The 2011 conversion factor was $33.9764. The 2012 conversion factor will be $34.0376. CMS/Palmetto won’t begin processing claims until January 18: CMS also indicated that because Congress acted so late in 2011 to prevent the 27.4 percent sustainable growth rate cut, claims will be held for a period of time to allow CMS to develop the new payment rate files, and to allow Medicare claims administration contractors to install and test the files. CMS expects that most if not all contractors will be ready to process claims under the revised rates on or before January 18, 2012, which is the end of the 10-business-day claims hold period (contractors’ time frames may differ). Palmetto will merge held claims, oldest receipt date first, with incoming claims, up to the maximum that can be accommodated by the common working file. New fee schedule will be posted on Palmetto website by January 11, 2012. On January 4, 2012, CMS published a correction notice in the Federal Register to the 2012 final rule that modifies the relative values for a number of services. The agency also posted a revised relative value file on its website reflecting both the corrections and the legislation that stopped the 27.4 percent cut. Comments are closed.
