Payment Matters: CMS Releases Calendar Year 2012 Physician Fee Schedule Final Rule with Comment Period

Baker Donelson
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This article was previously published as an email alert by the AHLA Physician Organizations Practice Group on November 4, 2011.

CMS has released its Calendar Year (CY) 2012 Final Rule with Comment Period for practitioners who are paid under the Physician Fee Schedule (PFS). The final rule impacts a variety of methodologies used to calculate physician payment, including the adjustment for geographic differences in practice expenses and the payment rates for the professional component of multiple advanced diagnostic imaging procedures. The final rule may be viewed here (see full alert below for link).

CMS anticipates that, without changes to current law, the Sustainable Growth Rate (SGR) adjustment to physician reimbursement will result in a 27.4 percent cut in payment rates for 2012. This adjustment has historically been reversed through congressional intervention. However, in light of the ongoing impasse over budget cuts required by this summer’s debt ceiling debate, the possibility looms that no legislative fix will be forthcoming. As a result, there is a very real possibility that a substantial reduction in physician reimbursement will occur with the CY 2012 PFS.

Please see full publication below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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