CMS Slashes Conversion Factor for 2011, Establishes Preventive Visit Codes

November 9, 2010

Get ready for another year of nail-biting to find out if your Medicare payments will be slashed. “The calendar year 2011 Physician Fee Schedule conversion factor is $25.5217,” notes the 2011 Medicare Physician Fee Schedule Final Rule, printed in the Federal Register that will be published on Nov. 29. This amounts to a dismal 30 percent cut compared to the current rate of $36.8729.

Plus: If you perform a procedure that meets CMS’s description of an annual wellness visit, you should not report a code from CMS’s preventive medicine section to your Part B carrier, the Final Rule indicates. CMS does not pay for preventive medicine services billed under 99381-99397. Instead, report one of the following newly-established HCPCS codes:

G0438 — Annual wellness visit; includes a personalized prevention plan of service (PPPS), first visit
G0439 — Annual wellness visit; includes a personalized prevention plan of service (PPPS), subsequent visit.

Get this: Some specialties will be facing cuts of up to 14 percent next year on top of the fee schedule cuts mentioned above. For the full story on the Fee Schedule changes and an analysis of how it affects the various specialites, check out Part B Insider.

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