As of January 1, 2013 Medicare’s Physician Fee Schedule is due to be cut by 27% over the 2012 Fee Schedule. This is only for services on or after January 1, 2013. Medicare will continue to process claims for services on or before December 31, 2012 under the normal time frames. Current law states that clean electronic claims are not paid sooner than 14 calendar days after the date of receipt. Clean paper claims are not paid sooner than 29 calendar days after the date of receipt.
Since Congress has not passed legislation to eliminate the sustainable growth rate (SFR) formula CMS has to take steps to implement the negative update. CMS will post notifications by January 11, 2013 with more information about the status of any Congressional action that may avert this negative 27% adjustment and what the next steps will be. This may include delaying the processing and payment on claims for a short period in January 2013 to allow Congress to act.