Proposed fee schedule for 2011 contains a 6.1% paycut, coverage for annual wellness visits (From PartB News)

You'll see a 6.1% decrease in payments in 2011 if Medicare's proposed Physician Fee Schedule for 2011 goes through as is. That cut will come on top of the 21% reduction that has been delayed several times already this year.

CMS will also roll out a number of provisions contained in the Patient Protection & Affordable Care Act (PPACA), including coverage of an annual wellness visit. Payment for the first visit will be equivalent to a Level IV office visit for a new patient. Subsequent annual visits will be paid at the rate of a Level IV visit for an established patient, according to the proposed rule.

Other changes in the 2011 proposed fee schedule include:

• Primary care bonus: Doctors who have a primary specialty designation of family, internal, geriatric or pediatric medicine will be eligible for an incentive payment of 10% of their allowed charges if they meet certain requirements. Clinical nurse specialists, nurse practitioners and physician assistants are also eligible for the pay boost.
• Screening exams: Medicare will eliminate deductibles and copayments for covered preventive care services. This will also apply to colorectal cancer exams that begin as screening exams but become diagnostic or therapeutic based on findings during the test.
• Surgery bonus: General surgeons operating in Health Professional Shortage Areas (HPSAs) will be eligible for a 10% incentive payment for major surgeries performed between Jan. 1, 2011 and Dec. 31, 2016. The bonus would be calculated based on the physician fee schedule payment for the surgery and paid on a quarterly basis.
• PQRI & e-Rx: CMS will add more measures to the Physician Quality Reporting Initiative and allow group practices with fewer than 200 members to participate in the group practice reporting initiative and the group e-Prescribing initiative.
• Advanced imaging: Providers who offer advanced imaging services will see a 75% equipment utilization assumption in 2011 for expensive diagnostic imaging equipment used for diagnostic CT and MRI services.
• GPCI: "Frontier states" will receive a permanent 1.0 floor for the Practice Expense Geographic Practice Cost Indices (PE GPCI). Those states are Montana, Wyoming, Nevada, North Dakota and South Dakota.

Remember: You can submit comments on the 2011 proposed Physician Fee Schedule until Aug. 24 by going to: http://www.regulations.gov. The final rule is scheduled for release on Nov. 1, 2010.

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