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San Francisco Marin Medical Society Blog

Congress Approves Three-Month Medicare Payment Update Until SGR Fix Is Completed

Congress has adopted a 0.5% update to Medicare payments for three months, following a bipartisan vote of 64 to 36 in the Senate. The president is expected to sign the legislation on December 20.

The payment increase staves off a 24%cut required by the failed sustainable growth rate (SGR) formula and buys three months for Congress to complete its work on SGR repeal legislation without further disruption to the Medicare program.

The House Ways and Means Committee and the Senate Finance Committee passed bills to eliminate the SGR, which has plagued policymakers and physicians for more than a decade, and replace it with a stable payment system for future generations of physicians and the patients they serve. Click here to see a summary of the bills.

Medicare Impact on Physicians in 2014

  • There is NO ADDITIONAL Medicare sequestration cut of 2% in 2014. While Congress did not restore the Medicare sequestration cuts in the recent budget agreement, they did not impose additional cuts beyond the 2% sequestration cut that occurred in January 2013. 
  • Congress adopted a 0.5% Medicare payment increase for 3 months (Jan 1-March 31) in 2014 above the 2013 payment levels. This bridge provides times for Congress to finish the Medicare SGR repeal and payment reform bills in January 2014.
  • Congress stopped the 24% Medicare SGR payment cut slated to take effect on January 1, 2014 for 3 months to provide more time to finish the Medicare SGR repeal and payment reform legislation in January 2014.
  • Impact of the 2014 Medicare Fee Schedule: Please consult the fee schedule for the impact on your individual practice. While there is a 3.7% increase in the Medicare fee schedule conversion factor, it was made to make the fee schedule budget neutral due to the myriad of Relative Value Unit (RVUs) changes. There are so many changes in the 2014 fee schedule impacting physicians differently by specialty, codes billed, and geographic region, that it is better to consult the fee schedule for the impact on each individual physician or physician group. 

Physicians can use CMA’s Financial Impact Worksheet that allows doctors to enter the CPT code, frequency billed, old rate and new rate. It will automatically calculate the net impact to their practice. 

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