Your payments for reading and interpreting the results of diagnostic MRIs, CTs and ultrasounds are under siege by a major new provision in CMS’s proposed 2012 Medicare Physician Fee Schedule (PFS), an exclusive Part B News analysis shows. Under the proposal, the professional component (PC) of affected diagnostic imaging tests would be paid in full once for the most valuable CPT code, then paid at 50% of the fee schedule rate for the second and all subsequent codes.

Does the type of service you bill have any connection to your likelihood of getting an accurate payment from a private plan? How does the accuracy of private plans compare to Medicare, by service type? The charts this week dive deeper into the private payer vs. Medicare comparison.

One of our physicians unexpectedly resigned from our group practice. We obtained written permission from the doctor to use his national provider identifier (NPI) to bill for the services of a locum tenens doctor. We know locum tenens rules set a limit of 60 calendar days to bill for services under the regular/resigning physician and the clock starts to tick from the first day the locum sees a patient.

This table shows the projected payment impact of proposed relative value unit (RVU) changes by specialty, based on CMS's 2012 Physician Fee Schedule proposed rule.

Review this complete list of 119 codes that would be affected by CMS's proposed expansion of its multiple procedure payment reduction (MPPR) rule. The MPPR currently affects the technical component (TC) of these 119 codes, but CMS wants the MPPR to hit the professional component (PC) of these codes as well. This provision is being proposed in the 2012 Physician Fee Schedule proposed rule.