Final Rule for 2007 Physician Fee Schedule

November 5th, 2006 | Medicare

The final rule was announced sometime on November 1 after I left  Richmond and near as I can tell, posted on November 2 – when I gave my 9:30 AM presentation in New Orleans having only seen the Proposed Rule.  Probably the most significant difference is that there was an error in Table 8 of the Proposed Rule – Impact of Proposed Rule on and Estimated Physician Update on 2007 Payment for Selected Procedures.  This Table did not, in fact, include the effect of the estimated 5.1% cut in the conversion factor.  In the analogous Table in the final rule – Table 36 – the fees for the various CPT codes listed are about 5% less, considering rounding.

Aside from that, radiologists succeeded in mitigating some of the impact on their services during the Proposed Rule’s comment period. CMS deferred the second phase of the 25% cut in the technical component for same day contiguous scans (MR and CT) in part due to the DRA provision that required physician fee schedule-based imaging be paid at no higher a rate than the Medicare OPD rate.  The Proposed Rule had radiologists facing a 16% cut while the Final Rule is only 14%.  Diagnostic testing facilities also fared well in the comment period, reducing their estimated losses from 25% to only 18%.  Anesthesia and Pathology made no headway, and face cuts of 12% and 11%, respectively.

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