Billing Beat

CMS Proposes Policy, Payment Rate Changes for the Physician Fee Schedule in 2012

July 29, 2011

CMS issued a proposed rule that would update payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012. CMS is required to issue a proposed rule that reflects current law. Under current law, providers would face steep across-the-board reduction in payment rates, based on a formulañ the Sustainable Growth Rate (SGR) ñ that was adopted in the Balanced Budget Act of 1997. If it goes into effect, Medicare payment rates are projected to be reduced by 29.5 percent for services in 2012. CMS will accept comments on the proposed rule until August 30, 2011, and will review and respond to all comments in a final rule to be issued by November 1, 2011.

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