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medical society corner cell Home » Practice Resources » Payer Relations (SME) » Medicare/Medicaid » Medicare Billing 2006
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MEDICARE/MEDICAID
Medicare Billing For 2006


On February 8, 2006, President Bush signed the recently passed Deficit Reduction Act, which includes a provision to freeze the Medicare physician payments at the 2005 conversion factor (while utilizing the 2006 Relative Value Units).  The law reverses the 4.4 percent cut that took effect January 1. Medicare Carriers began processing new claims with the updated fee schedule on February 9, 2006.  Previously submitted claims will be automatically adjusted on an aggregated basis.  This process will take several months to complete.

The updated 2006 fee schedules are posted on the Medicare Carriers’ websites, as follows:


Physicians who do not have internet access, will need to contact the Medicare Carrier for a hard copy of the revised 2006 Medicare Physician Fee Schedule.

Please be sure to look at the chart provided. This chart provides a small/random sample of the impact the revised 2006 physician fee schedule will have for our members.  For your information, we compared the old 2005 fee schedule with the new and revised 2006 Medicare Physician Fee Schedule at the participating non-facility fees, only.


For nonparticipating Medicare physicians, there would be a 5% reduction to the participating fee schedule before applying the 115% Federal limiting or 105% NYS limiting charge.  Remember, the carriers were instructed to use the 2005 conversion factor and the 2006 relative value units (RVUs).  Therefore, it is NOT a true 2005 fee freeze.  Physicians must be aware of this!  It is important that all physicians utilize only the new and revised 2006 fees as posted on the Medicare Carrier websites.

Our work to reform the Medicare physician payment system is not done.  This freeze is a short-term solution; Medicare is not covering increases in physician practice costs and payment cuts that are slated for next year unless Congress takes additional action before the November elections.

We will be counting on the help of physicians to work with Congress to avert Medicare physician payments cuts in January 2007.  Together we need to tell Congress that physicians need more than one-year, stop-gap measures.  We need to replace the so-called Medicare sustainable growth rate with a payment system that provides annual updates that reflect increases in medical practice costs.  To contact your elected officials, please CLICK HERE.
 

Any questions may be directed to Ms. Regina McNally at MSSNY (516) 488-6100 ext. 332.