CMS Finalizes Calendar Year 2011 Physician Fee Schedule & Other Medicare Part B Payment Policies

Physicians and other health care providers providing services expected to be covered by Medicare Part B should evaluate and make appropriate billing and budgeting adjustments in response to final regulations (Final Regulation) governing the Medicare Part B reimbursement for physician and a broad range of other health care services 2011.

Published by the Centers for Medicare & Medicaid Services (CMS) today (November 29, 2010), the 692 page Final Regulation scheduled to take effect January 1, 2011 addresses:

  • Changes to the physician fee schedule and other Medicare Part B payment policies made by CMS to reflect changes in medical practice and the relative value of services;
  • Finalizes the calendar year (CY) 2010 interim relative value units (RVUs);
  • Issues interim RVUs for new and revised procedure codes for CY 2011;
  • Addresses certain provisions of both the Affordable Care Act (ACA) and the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
  • Discusses payments under the Ambulance Fee Schedule (AFS), the Ambulatory Surgical Center (ASC) payment system, and the Clinical Laboratory Fee Schedule (CLFS),
  • Discusses payments to end-stage renal disease (ESRD) facilities,
  • Discusses payments for Part B drugs; and
  • Discusses Chiropractic Services Demonstration program, the Competitive Bidding Program for durable medical equipment, prosthetics, orthotics, and supplies (CBP DMEPOS), and provider and supplier enrollment issues associated with air ambulances.

For More Information or Assistance

A copy of the Final Regulation is available for review here.

If you need assistance evaluating or responding to this development of other health care reimbursement, technology and process, compliance, risk management, transactional, operational, enforcement or public policy concerns, please contact the author of this update, Cynthia Marcotte Stamer, at (469) 767-8872, cstamer@Solutionslawyer.net.

Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 23 years experience advising health industry clients about these and other matters.  She continuously advises health industry clients about the use of technology, process and other mechanisms to promote compliance and internal controls, workforce and medical staff performance, quality, governance, reimbursement, and other risk management and operational needs. As part of this experience, she has worked extensively with health care providers, payers, health care technology and consulting and other health industry clients on the design and use of health information systems, technology, privacy and other related. A popular lecturer and widely published author on health industry concerns, Ms. Stamer also publishes and speaks extensively on health care privacy, technology, and other health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns. Her insights on these and other related matters appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications. To review some of her many publications and presentations, or for additional information about Ms. Stamer, her experience, involvements, programs or publications, see here.

Other Recent Developments

If you found this information of interest, you also may be interested in reviewing some of the following recent Updates available online by clicking on the article title:

For More Information

We hope that this information is useful to you.  You can review other recent health care and internal controls resources and additional information about the health industry and other experience of Ms. Stamer here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile at here or e-mailing this information here.

©2010 Cynthia Marcotte Stamer.  All rights reserved.

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