Proposed 2013 Medicare physician fee schedule for top 10 Anesthesia & Pain codes
The proposed 2013 Medicare physician fee schedule contains a 27% pay cut for the top 10 anesthesia codes. The following chart provides a snapshot of how the reimbursement for anesthesia and pain management practices will be effected in 2013 for 10 of the most commonly billed codes unless Congress takes action to halt the pay cut.
The codes were selected based on the most recent utilization data for anesthesia and pain management specialists. The fees shown are for services performed by a participating physician in a non-facility setting. They have not been adjusted for locality.
|
Code |
Description |
2012 Fee |
2013 Fee |
|
20610 |
Drain/inject joint/bursa |
$69.78 |
$50.58 |
|
27096 |
S/I Joint Injection |
$171.55 |
$124.34 |
|
62310 |
Inject spine cervical/thoracic |
$246.77 |
$178.87 |
|
64483 |
Inj foramen epidural l/s |
$242.01 |
$175.41 |
|
64493 |
Inj paravert f jnt l/s 1 level |
$181.08 |
$131.25 |
|
77003 |
Fluoroscopic guidance |
$64.67 |
$46.88 |
|
99203 |
Office visit – new patient |
$105.18 |
$76.23 |
|
99204 |
Office/outpatient visit new |
$160.66 |
$116.45 |
|
99213 |
Office/outpatient visit est |
$70.46 |
$51.07 |
|
99214 |
Office/outpatient visit est |
$104.16 |
$75.49 |
CMS Finalizes New Regulation to Standardize Electronic Funds Transfer (EFT)
The Centers for Medicare & Medicaid Services (CMS) announced that the interim final rule that adopts healthcare electronic funds transfer (EFT) standards is now a final rule currently in effect. According to CMS, the standards for EFT could reduce administrative costs for physician practices and others by up to $4.5 billion over the next ten years. The rule is the second in a series of regulations mandated by the administrative simplification section of the Affordable Care Act. The final rule outlines two standards that health plans must comply with in order to use EFT to transmit healthcare claim payments to providers.
- First, health plans are required to use a standard format when ordering, authorizing or initiating an EFT with their banks.
- Second, the rule outlines the data content of the EFT.
Health plans and other covered entities must comply with the provisions of the EFT rule by Jan. 1, 2014. However, CMS indicates that health plans are permitted to use the EFT standards with willing trading partners before that date. Practices not already receiving EFT payments should contact their practice management system software vendor and health plans to discuss incorporating this transaction into their claims revenue cycle workflow.
Read full regulation in the federal register.
