AMA Update on Medicare Payment Rates January 3, 2013 AMA, Medicare, News, Politics and Medicine SGR, American Taxpayer Relief Act of 2012, Fiscal Cliff, Medicare 0 The American Taxpayer Relief Act of 2012 was signed into law January 2, 2013. The new law averts the 26.5% SGR cut for all of 2013 and the 2% sequester for the next two months. It also extends the work GPCI floor for a year. Today CMS released the attached announcement regarding updated 2013 Medicare payment amounts, claims processing, and reopening of the participation enrollment period. Carriers are not expected to post the new rates on their web sites until at least next week and possibly later. In the meantime, some practices are asking what they should charge. By law, Medicare is required to pay physicians the lesser of the submitted charge or the Medicare approved amount. For this reason, the SFMS is advising against submitting claims with the reduced 2013 amounts. Instead, we recommend physicians either defer submission of claims for 2013 dates of service until the new 2013 rates are published, or continue charging the 2012 rates. In addition, due to relative value changes that will affect some 2013 payment amounts and limiting charges, for unassigned claims practices should probably wait to bill patients directly for cost-sharing amounts until the new 2013 rates are published. Source: American Medical Association Comments are closed.
