Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95
Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

Medicare Starts Processing Claims at $28 Conversion Factor

SuperCoder Posted Fri 18th of June, 2010 18:09:41 PM

Expect $14 less for 99213, starting June 18.

Bemoaning Medicare shortfalls? The situation just got worse.
The Senate failed to pass the American Jobs and Closing Tax Loopholes Act (H.R. 4213) late Thursday night. The clock ran out on the claims hold that expired June 17 that was delaying payment processing at the cut rate.

Result: Medicare contractors may start processing claims starting today, June 18, at the -21.3 percent cut. That puts the new conversion factor rate at 28.3868, down from 36.0846.

You’ll get almost $14 less per 99213. For 99213, Medicare was paying an unadjusted rate of $65.67, which under the new CF will be reduced to $51.66.

The future may be rosier. As in past years, Congress is expected to intervene and repeal the Medicare Physician Fee Schedule cut retroactively to June 1st. In this case, CMS contractors will automatically reprocess all claims with dates of service on June 1, 2010 or later (and thus subject to the fee cut) to capture that additional payment.

Related Topics