On July 12, the Centers for Medicare and Medicaid Services (CMS) released the proposed 2019 Medicare Physician Fee Schedule (PFS) addressing Medicare payment and quality provisions. CMS estimates that the physician rule will decrease payments to radiation oncology and radiation therapy centers by 2% from 2018 to 2019. Table 94 of the Proposed Rule shows the CY 2019 PFS Estimated Impact on Total Allowed Charges by Specialty. Click to view or download Table 94: CMS-1693-P Table 94
Much of the specialty level impact is being driven by CMS’s proposal to establish a single payment rate for new patients and a single PFS rate for established patients for E/M visits levels 2-5. With the budget neutrality adjustment to account for changes in RVUs, all required by law, the proposed 2019 PFS conversion factor is $36.05, a slight increase above the 2018 PFS conversion factor of $35.99.
With declining reimbursement rates, there's no better time to check with your revenue cycle management provider to ensure your radiation oncology coding, billing and collections are optimized. Click to learn more or call New Bedford for a consultation.