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American Association of Hip and Knee Surgeons

Advocacy, Education, Research

Medicare 2015 Fee Schedule Released

On July 3rd, CMS released their proposed 2015 physician fee schedule. The final rates and policies will be effective January 1, 2015.

Among other things, the Proposed Rule would refine the physician work and practice expense (PE) resource-based relative value units (RVUs) and make changes to the payment rates for services paid under the MPFS. CMS expects reimbursement for orthopaedic surgery to be relatively constant (0% change) in 2015 – although that does not take into account potentially-steep cuts attributable to the statutory Sustainable Growth Rate (SGR) update formula looming effective April 1, 2015. CMS also does not address its ongoing review of the work RVUs for total hip and total knee arthroplasty, announced in last year’s final rule.

Also of note, CMS is “proposing to transform all 10- and 90-day global codes to 0-day global codes beginning in calendar year 2017,” CMS said. “The Office of the Inspector General has identified a number of surgical procedures that include more visits in the global period than are being furnished.” The agency plans to have one code for services provided on the day of surgery, and pay separately for postsurgical services.

 

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