Medicare 2009 Prep Talk

Back in July, Congress managed to put off huge cuts projected for your Medicare payments in 2009, instead promising a whopping 1.1 percent raise. Still, this does not mean your particular practice will see the same or slightly better returns from Medicare. Here’s why:

• That mini-raise applies only to the conversion factor. To figure out what to pay you, Medicare multiplies its practice expense, work, and malpractice relative value units (RVUs) by this annual conversion factor.

• The conversion factor may go up, but if the RVUs for specific codes you use a lot go down, the end result is still lower payments for you. Apply the same logic for seeing the difference between multiplying 2 x 2 and 3 x 2. So even if there is an overall 1.1 percent increase, you still need to study the impact for your specific practice.

A little preparation will go a long way to a better 2009. Therefore, now is the time to forecast your Medicare payments so you can prepare for any impact. You’ll need some data to do that, which, frustratingly, is not fully available. As of today, Medicare has not yet released its final RVUs and fee schedule. However, it has released its proposed fee schedule, and projected the impact of RVU changes by specialty and by specific codes. Those estimates were printed in the Federal Register. Go to pages 96 and 97 in the PDF and look for charts 28 and 29.

Note that when Medicare does finally release the 2009 schedule, it will be posted online. Bookmark this site for easy reference later on. While you wait for the final fee schedule, you can start reviewing already-publishedchanges to the ICD-9 code set and update your superbills to suit. Heads up: You’ll find many additions to the diabetes codes.

There’s no need to panic about all of this. Keep in mind that according toPhysicians Practice research,Medicare generally pays better these days than many commercial plans. Don’t reject Medicare out of hand, simply because their machinations are so public. But help yourself out by taking time to prepare for the coming onslaught of new information.

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Pamela L. Moore, PhD, CPC, is editorial director for Physicians Practice. She can be reached at pmoore@physicianspractice.com.