Medicare to Proceed with 21% Payment Reduction

The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent (0%) update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010. At this time, Congress is debating the elimination of the negative update that took effect June 1, 2010. The Centers for Medicare & Medicaid Services (CMS) is hopeful that Congressional action will be taken within the next several days to avert the negative update.

To avoid disruption in the payment of claims for radiologists, CMS had instructed its contractors on May 27th to hold claims for services paid under the MPFS for the first 10 business days of June (i.e., through June 14, 2010). This hold affects MPFS claims with dates of service of June 1, 2010 and later.

Given the possibility of Congressional action in the very near future, CMS is now directing its contractors to continue holding June 1st and later claims though Thursday, June 17th, lifting the hold on Friday, June 18th.

This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if Congressional action changes the negative update.

This delayed processing of Medicare claims will adversely impact cash flow for our clients. This is an unfortunate result of a dysfunctional legislative process. We will provide more information regarding the 2010 Medicare Physician Fee Schedule update as it comes available.

ADVOCATE will continue to provide updates as they become available.

With best regards,
Kirk Reinitz, CPA