Summary: Changes to relative value units (RVUs) in the final 2011 Physician Fee Schedule (PFS) will bring big changes next year, completely independent of what Congress ultimately decides to do with the Medicare cut now set for Jan. 1 (see related story). This chart examines 12 high-utilization services, dividing them into six that see the greatest payment increases and six that see the smallest increases, or in some cases a decrease, in the New Year.

You should already be reaching out to your clearinghouses and vendors to make sure you know what their plans are for the transition to the ICD-10 diagnosis coding system, now set to take place on Oct. 1, 2013, according to Tony Trenkle, director of CMS's office of e-health standards and services.

Medicare Administrative Contractors (MACs) confirm that your claims won't be rejected because of ordering/referring provider issues come Jan. 3 (PBN 11/15/10). CMS had previously announced when items and services require an ordering/referring provider and that provider is not in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) - the claim will not be paid.

When you know that certain services cost you money or barely break even when furnished, you must take action to cut your losses. In a climate of uncertain and often declining reimbursement, where flat payments are good news, proactive practices will come out on top, experts. Use these four field-tested tactics to staunch the bleeding from services whose payments can't keep up with the overhead of providing them.

Download the release notes and measure specifications for the 2011 Physician Quality Reporting System (PQRS) right from www.partbnews.com. You will need these documents to accurately report quality data codes to CMS next year.

Try these three ways to deal with most favored nations (MFN) clauses, starting with Strategy #1: Remove the MFN clause. The best way to deal with a MFN clause is to delete it from your contract, consultants say.

The new subsequent observation codes (99224-99226) could become an alternative for you and your peers to bill when a physician provides a consultation service to a patient in observation. AMA officials say the codes are designed to be reported by both the physician who initiates observation care and any other doctor who evaluates the patient.

Use these five tips to get your practice's new e-prescribing system up and running. In less than one month, CMS will start to analyze your claims to determine whether your practice will be penalized. Remember:  Your Medicare payments will be reduced by 1% in 2012 when you're eligible for a 2011 e-prescribing bonus but you don't report on claims with HCPCS code G8553 at least 10 times between January and June.

You've been granted a one-month reprieve from a 23% sustainable growth rate (SGR) cut to your Medicare payments. Congress passed a law to prevent the cut from hitting on Dec. 1, but a 30% overall pay reduction still awaits your practice on Jan. 1.