On April 14, 2015, Congress passed the Medicare Access and CHIP Re-authorization Act of 2015, which the President is expected to sign shortly. This law eliminates the negative update of 21% scheduled to take effect on April 1, 2015 for the Medicare Physician Fee Schedule.
In an effort to minimize financial effects on providers, CMS previously instituted a 10-business day processing hold for all impacted claims with dates of service April 1, 2015 and later. While the Medicare Administrative Contractors (MACs) have been instructed to implement the rates in the legislation, a small volume of claims will be processed at the reduced rate based on the negative update amount. The MACs will automatically reprocess claims paid at the reduced rate with the new payment rate.
As always, ADVOCATE will keep you up to date on this and all issues impacting radiology as they become available.
Kirk Reinitz, CPA