News From the College

ACS Comments on 2013 Fee Schedule, Outpatient Payments


 

The ACS submitted comments in August to the Centers for Medicare & Medicaid Services (CMS) concerning the proposed calendar year 2013 Medicare physician fee schedule, notably on these topics:

• A proposal to create a new G-code that can be billed by physicians who coordinate services for a beneficiary after discharge from a hospital.

• A new Physician Quality Reporting System (PQRS) reporting option to use administrative claims to avoid the 2015 and 2016 payment adjustments.

• Implementation of the physician value-based payment modifier, which would apply to some physicians starting in 2015 and all physicians by 2017. This budget-neutral payment modifier will provide for differential payment to a physician or a group of physicians under the physician fee schedule based on the quality of care furnished compared to cost. Go here to view comments and other issues discussed in the letter.

The ACS also submitted comments in August to the CMS concerning the proposed calendar year 2013 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) payment rule. The letter recommends adding several laparoscopic partial colectomy codes to the list of procedures that may be performed only in an inpatient setting. Also addressed were hospitals treating beneficiaries as outpatients in lieu of admitting them and 16 procedures that the CMS proposed to add to the list of procedures that may be performed in an ASC.

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