Physician Fee Schedule Final Rule Published
On November 15, 2004, CMS published the Final Rule for Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005.
The regulations are effective on January 1, 2005. In general there is a
1.5% increase in physician payments. The nursing home codes, subject to
site of service differentials for facility and non-facility visits with
the implementation of the 2002 physician fee schedule, saw decreases in
payment for procedures in non-facility settings with an increase in
payments in facility settings.
There now is no differential between facility and non-facility
actual reimbursement. The raise will be implemented through the
conversion factor, which is adjusted each year. The 2004 conversion
factor was $37.3374. With a 1.5% increase, the new conversion factor is
$37.8975. Payment for a particular code is determined by multiplying
the conversion factor by the Relative Value Units (RVU). These figures
do not include any geographic adjustments.
The total estimated payments table for the nursing home codes can be viewed online at www.amda.com/federalaffairs/feeschedule2005.htm.
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