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The Florida Society of Ophthalmology

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Update on Medicare Payments and Rule Changes

As previously reported, CMS contractors will be holding all 2012 claims processing for up to 10 business days. The delay will allow CMS to develop and implement the new payment rate files, and completely test them. All 2012 claims should be released by January 18. There will be no delay in payments for claims with service dates occurring prior to January 1, 2012.

Except for the Medicare pay cut all other changes included in the Medicare physician payment final rule for 2012 will still take effect. While the physician fee schedule update will be zero percent, other changes to the relative value units used to calculate the fee schedule rates must be budget neutral. To make those changes budget neutral, the conversion factor must be adjusted for 2012. CMS is currently developing the 2012 Medicare Physician Fee Schedule (MPFS) to implement the zero percent update. The 2011 conversion factor was $33.9764. The 2012 conversion factor will be $34.0376. CMS published in the Jan. 4, 2012, Federal Register a correction notice to the 2012 final rule that modifies the relative values for a number of services. The agency also posted to its web site a revised relative value file reflecting both the corrections and the legislation that stopped the 27.4% cut. Medicare contractors will be posting the new rates on their websites no later than January 11, 2012.




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