Monday, July 13, 2015

Emergency update to the 2015 Medicare physician fee schedule database


Effective date January 1, 2015
Implementation date: January 5, 2015

Summary
The Centers for Medicare & Medicaid Services (CMS) recently released an emergency update to Medicare physician fee schedule database payment files.

With the emergency release, CMS amended those payment files, including an updated conversion factor of $35.7547 for services furnished between January 1, 2015, and March 31, 2015. CMS also corrected errors made in work, practice expense and malpractice relative value units.

Payment files were issued to contractors based upon the CY 2015 MPFS Final Rule, displayed on October 31, 2014 (and published in the Federal Register on November 13, 2014). CR9081 amends those payment files in order to correct technical errors to the MPFS update files, including an updated conversion factor of $35.7547 for services furnished between January 1, 2015, and March 31, 2015, consistent with the Protecting Access to Medicare Act of 2014 that provides for a zero percent update from the CY 2014 rate.

In preparing the CY 2015 final rates, errors were made in work, practice expense and malpractice RVUs. In correcting these errors and making adjustments to reflect the policies in the CY 2015 final rule with comment period, relativity adjustments were required across the fee schedule, and the conversion factor was adjusted from that published in the final rule. The amended payment files reflect all these changes and a conversion factor of $35.7547 for services furnished on or after January 1, 2015, and on or before March 31, 2015.



Under current law, a new conversion factor will be required for services furnished on or after April 1, 2015. These files will be provided with the April quarterly update.

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