November 01, 2015
CMS Releases Medicare Physician Fee Schedule Final Rule
Update: CMS has issued a correction to the 2016 Medicare Anesthesia Conversion Factor.
The Centers for Medicare & Medicaid Services (CMS) has released its final rule for the CY 2016 Medicare Physician Fee Schedule.
Preliminary review demonstrates that the unadjusted anesthesia conversion factor for services provided in 2016 will be $22.3309. The conversion factor for pain medicine and other services paid under the Resource Based Relative Value System (RBRVS) will be $35.8279. ASA has carefully reviewed the calculations behind the anesthesia conversion factor and has contacted CMS with our concerns.
CMS still believes that emergency intubation and placement of central venous lines, arterial lines and PA catheters may be potentially misvalued and should be reviewed via the AMA/Specialty Society RVS Update Committee (RUC) process. CMS is also standing firm on its belief that anesthesia for upper and lower GI endoscopy should be reviewed by the RUC.
ASA also recognized CMS’s interest in expanding public reporting of individual eligible provider (EP)-level Physician Quality Reporting System (PQRS) and non-PQRS measure data submitted through the Qualified Clinical Data Registry (QCDR) mechanism. As such, ASA supported the group practice reporting option for members to satisfactorily participate in PQRS via the QCDR mechanism. The availability of this option will be beneficial to ASA members as it may address some of the concerns different physician anesthesiologists had with meeting QCDR reporting criteria.”
ASA supported the continued use of each PQRS reporting mechanisms, including the use of claims-based reporting for a number of measures within PQRS 2016. ASA appreciates the inclusion of additional measures into PQRS but is disappointed that the agency did not finalize the use of such measures in a way conducive to the reporting mechanism that most anesthesia providers report.
Additional detail will be provided as ASA continues its analysis of the rule.