Complete Story
06/28/2010
Medicare Physician Fee Schedule - Update
CMS requires contractors process claims with new rates no later than July 1, 2010.
As Highmark Medicare Services (HMS) reported on June 25, 2010, as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, the Medicare Physician Fee Schedule was updated to apply a 2.2% increase for dates of service June 1, 2010 and after. CMS required contractors to start processing claims with the new rates by no later than July 1, 2010. Please see the bulletin dated 06/25/2010 for more information.
HMS Current Status: The new 2.2% Medicare Physician Fee Schedule was loaded to production for both Part A and Part B services on Friday night, June 25th. The production files were validated by HMS staff on Saturday, June 26th. As of Monday night, June 28th, HMS began releasing previously held claims with June dates of service for payment using the new fee schedule. HMS will process claims first in, first out, processing the oldest claims first. As a reminder, claims received for services rendered prior to June 1st, will continue to be processed using the previously established 0% Medicare Physician Fee Schedule.
As reported previously, prior to the passage of the new law, CMS required contractors to begin paying claims at the negative 21% Medicare Physician Fee Schedule update. HMS processed Part A and Part B claims with June 1st and after dates of service, received on June 1st, 2nd and 3rd at the negative 21% fee schedule. At CMS direction, HMS will automatically reprocess these claims using the new 2.2% fee schedule. We expect to initiate these adjustment claims by no later than July 9th. Providers do not need to take any action to have these claims reprocessed.
We will publish additional updates as we work through the release of the held claims and the reprocessing of the claims paid at the negative 21% fee schedule.
https://www.highmarkmedicareservices.com/bulletins/all/news-06252010.html
