Beginning in November 2010, the AASM sent out regular updates to members related to the 2011 Medicare Physician Fee Schedule (MPFS) Final Rule. To avoid confusion and help clarify payment changes, we have developed an overview of the MPFS Final Rule including a timeline of events, national payment information, instructions for finding local payment information and a glossary of key terms.

New legislation and recent corrections to the 2010 Medicare Physician Fee Schedule (MPFS) call for reprocessing of a large volume of Medicare fee-for-service claims. Given this large workload, the Centers for Medicare & Medicaid Services (CMS) is taking steps to ensure that new claims coming into the Medicare program are processed timely and accurately, even as the retroactive adjustments are being made.

Effective Oct. 1, 2013, diagnostic coding in all health-care settings will change from ICD-9 to ICD-10.  To accommodate the changes to the code structure resulting from this transition, CMS is requiring an update to the transaction standards used for electronic health-care claims.  The current standards, Version 4010/4010A, must be upgraded to Version 5010 by Jan. 1, 2012.

Effective Oct. 1, 2013, diagnostic coding in all health care settings will change from the International Classification of Diseases Ninth Revision (ICD-9) to the Tenth Revision (ICD-10). Hit the jump to learn the highlights the biggest differences between the ICD-9 and ICD-10.

On Wednesday President Obama signed into law “The Medicare and Medicaid Extenders Act of 2010” (HR 4994), which will extend current Medicare reimbursement rates until Jan. 1, 2012.
The law prevents the scheduled reduction to the overall rate of physician reimbursement for services provided to Medicare beneficiaries. The conversion factor, one of the key elements of the Medicare payment formula, will remain at $36.87 for 2011.

Published in the 2011 Physician Fee Schedule is information on payment for sleep medicine codes, including national values for physician work, practice expense and professional liability insurance RVUs. The new values for the RVUs are effective January 1, 2011.