LogixHealth Analyzes the Emergency Update to the CY 2016 Medicare Physician Payment Schedule

BEDFORD, MA--(Marketwired - Feb 24, 2016) -  LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across 35 states, and has analyzed the implications of the emergency update to the calendar year 2016 Medicare Physician Payment schedule.

On November 16, 2015, the Centers for Medicare and Medicaid Services (CMS) published the 2016 Medicare Physician Fee Schedule Final Rule (CMS-1631-FC) in the Federal Register. Importantly this is the first publication of the Physician Rule and associated payment rates since passage of the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), which repealed the Sustainable Growth Rate formula.

MACRA instituted a one-half percent (0.5%) physician payment increase on July 1, 2015, and an additional 0.5% for 2016. The 2016 conversion factor started at $35.9335, however a 0.77% Target Recapture Amount reduction was applied based upon a statutorily mandated misvalued code adjustment, in addition to a -0.02% Budget Neutrality Adjustment, yielding a conversion factor of $35.8279.

CMS recently announced an emergency 2016 Physician Payment update due to a technical correction. This correction, which applies retroactively to January 1, 2016 results in small changes to the Practice Expense Relative Value Units for certain services and a two-cent conversion factor reduction to $35.8043. Change Request 9495 amends payment files that were issued to contractors based on the initial CY 2016 Medicare Physician Fee Schedule Final Rule.

"While the RVUs for certain services did have small minor adjustments the Emergency Department E/M services (CPT codes 99281-99285) remained unchanged," states Michael Granovsky, President of LogixHealth.

Payment files were initially issued to contractors based upon the 2016 Medicare Physician Fee Schedule (MPFS) Final Rule, and were published in the Federal Register on November 16, 2015. The recent technical correction reflected in Change Request 9495 amends the initial payment files and incorporate corrections described in the CY 2016 MPFS Correction Notice, and correct technical errors to the MPFS update files.

About LogixHealth:
LogixHealth, a leading provider of internet and software enabled coding, billing, analytics and management services for hospital and physician practices nationwide, provides services for millions of Emergency Department (ED) visits across over 35 states. We provide tools and resources to optimize financial performance and improve the quality of care. For more information, visit www.logixhealth.com.