New Medicare Fees Not What Anticipated

News that Medicare cuts had been delayed left many physicians believing that their 2011 Medicare fees would be the same as their 2010 fees. Not necessarily. There are many components in the Medicare physician fee calculation. While the conversion factor is the largest and has the most impact on the fee, the combined impact of changes in other components can result in fairly significant changes in some fees.
Here are some of the components that impacted 2011 fees:

  • Changes in the physician work and malpractice relative value units (RVUs)
  • Transitional changes in the practice expense RVU and the multiple procedure payment reduction (MPPR)
  • Rebasing the Medicare economic index (MEI) from 2000 to 2006 costs

The effect of these individual changes may be quite small. When combined, however, the impact is noteworthy for some specialties.  Since the law requires that these changes be made in a budget neutral fashion, the conversion factor was reduced by 8.3 percent from $36.8729 to $33.9764 as an offset.
The full impact ranged from an estimated 5 percent increase for anesthesiology to a 10 percent decrease for radiology.  You may download the 2011 Medicare fee schedule from the Highmark Medicare Services website.

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Last Updated: 8/19/2011
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