American Taxpayer Relief Act of 2012 Signed by President Obama
Medical providers are relieved that the 27% reduction in the Medicare Physician Fee Schedule (MPFS) will not go into effect January 1, 2013. President Obama signed the American Taxpayer Relief Act of 2012 on Wednesday, January 2, 2013. This law provides for a 0% update to the MPFS for services from January 1, 2013 through December 31, 2013.
This does not mean that the fee schedule will stay exactly the same as it was in 2012. There are some technical corrections that need to be done to the fee schedule and the new 2013 conversion factor of $34.0230 will be applied. This may mean a decrease in the fee schedule for most services.
Medicare Contractors will be holding claims for dates of service in 2013 for up to 10 business days to allow themselves time to load the new fee schedule into their systems. Providers should not notice a delay in payment since clean Medicare claims that are submitted electronically cannot be paid sooner than 14 calendar days after the date of receipt. Claims with dates of service prior to January 1, 2013 are not affected by the fee schedule update.
This new law also extends the automatic exception policy for outpatient therapy services through December 31, 2013. The therapy caps for 2013 are $1,900.00 for physical therapy and speech language pathology and a separate $1,900.00 for occupational therapy. Medically necessary services above these cap amounts may be submitted with the KX modifier to Medicare for payment.
The law also extends the manual medical review of therapy services for 2013 dates of service. Providers must request a pre-approval for therapy services that will exceed the $3,700.00 threshold amount for the calendar year. This threshold amount is also separate for physical therapy/speech language pathology and occupational therapy.
Superior Medical Billing Solutions is always keeping up to date with the latest changes in Medicare policy and legislation that affects the medical community. Contact us at 888-520-9330 or firstname.lastname@example.org if you would like to see how we can help you and your practice stay financially healthy.