The numbers: To keep the reimbursement rate the same, Congress passed a freeze on Dec. 9 that, if enacted, will keep the CF at the current 2006 rate of 37.8975 instead of decreasing it to the proposed 2007 rate of 35.9848. -President Bush is expected to sign the measure in the next week,- says Robert B. Doherty, senior vice president of governmental affairs and public policy for the American College of Physicians. 2. Calculate Fees With Transitional RVUs A freeze, however, does not mean CPT code payments will remain the same in 2007. Because of the five-year review, the CF tells only part of the story, Still says. To calculate a CPT code's payment, you also need to look at any changes to the code's work and practice expense (PE) relative value units (RVUs).
Do this: When determining a code's payment rate, make sure to choose the total RVU that represents the current year. -The transitional columns [P and R] indicate the current values that apply,- Still says. To get a long-range look at what you can expect those values to ultimately become, look to the code's fully implemented total RVUs (columns Q and S), which will become effective in 2010.
3. Expect Cognitive Work Hike Despite Objections
Higher RVUs for some E/M services make a difference for some ENTs, but the hike won't matter much, says Andrew Borden, CCS-P, CPC, reimbursement manager in the department of otolaryngology and communication sciences at the Medical College of Wisconsin in Milwaukee. -The majority of our income is from surgical and procedural coding.-
Example: CMS assigned an additional 0.25 work RVUs to 99213 (Office or other outpatient visit for the evaluation and management of an established patient ...). That increase, plus a slight PE raise, will result in more than an additional $9-10 for level-three visits as noted below:
*Note: 2007 values, except work, listed in this article are all transitional and use the 2006 CF of 37.8975. The American Academy of Otolaryngology -- Head and Neck Surgeons (AAO-HNS) [...]