The Centers for Medicare & Medicaid Services (CMS) has posted on its Web site the final rule for 2008 Medicare physician payment schedule. The rule, which will be published in the November 27, 2007, Federal Register, is available for download from

The provisions of the final rule are effective January 1, 2008, with noted exceptions. There will be a 60-day open comment period that begins November 27, 2007. Comments can be remitted to CMS online at Click on the link, "Submit electronic comments on CMS regulations with an open comment period." The rule addresses several issues of importance to sleep medicine specialists.

Beginning January 1, 2008, a 10.1 percent cut in the Medicare conversion factor goes into effect as well as a 0.1 percent reduction for the sustainable growth rate; the 2008 conversion factor will be $34.0682. However, it should be noted that payment rates for specific services in certain localities may have different percentage payment cuts. The rule addresses Independent Diagnostic Testing Facilities (IDTF) issues. Specifically, it clarifies CMS interpretation of several of the existing performance standards related to existing performance standards, proposes new IDTF standards, and includes a new proposed IDTF provision. The section on IDTFs includes comments CMS received during its revision of the existing standards with a response as rationale for the changes.

Also detailed in the final rule are refinements to resource-based practice expense relative value units (RVUs); geographic practice cost indices (GPCI) changes; physician self-referral issues; and a durable medical equipment (DME) update. The rule includes the final list of quality measurers for the 2008 Physician Quality Reporting Initiative. Full specifications for each measure in the initiative will be posted on the CMS Web site in the near future.Members of the AASM staff are currently reviewing the final rule and will provide an analysis to members in the coming weeks. Look for more information to be posted on the Web site.