American College of Physicians: Internal Medicine — Doctors for Adults ®

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Policy Briefs

From the October 2000 ACP-ASIM Observer, copyright 2000 by the American College of Physicians-American Society of Internal Medicine.

Proposed Medicare fee schedule includes College recommendations

The proposed 2001 Medicare physician fee schedule included some, but not all, of the College's recommendations.

HCFA included the following College recommendations in the schedule:

  • Use more recent practice expense survey data from the AMA's Socioeconomic Monitoring Survey.
  • Allow clinical office staff time to be reimbursed for certain outpatient procedures.
  • Restore to historic levels the work relative value units for current procedural terminology (CPT) critical care codes.

HCFA did not incorporate the following College recommendations:

  • Pay for pulse oximetry on the same day as an evaluation and management service.
  • Conduct sensitivity analyses on practice expense refinements, as the General Accounting Office advised.
  • Establish a methodology to accept a "j" code for unusual equipment costs associated with a procedure.

HCFA's final fee schedule is scheduled to be published in November. College officials said they hope that HCFA will consider adding these and other recommendations to the final publication.

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