Cliff Averted: Medicare Fee Schedule Intact

We all received some good news in the early hours of 2013. On January 1, 2013, Congress approved legislation that prevents the scheduled SGR and sequestration cuts to the Medicare fee schedule. The 26.5% SGR cut has been delayed until early March, when the legislation will be reviewed again. Congress approved a one-year freeze in the Medicare conversion factor, and has extended several Medicare Provider Payment provisions, while also implementing “offsets”.

As CMS reminded providers in its 12/19/2012 bulletin, clean electronic claims are never paid sooner than 14 calendar days after the date of receipt. CMS has promised to issue further notification before January 11, 2013 with an update on its progress in updating its fee schedule (remember, CMS was forced to load the 2013 fee schedule with the projected pay cuts, since Congress acted so late in averting the cuts). It is our hope that CMS will be able to work quickly enough within these next two weeks in order to avoid having to reprocess claims for 2013 dates of service.