By Kelly A. Briganti, Editorial Director, G2 Intelligence
This past year brought many unwelcome reimbursement developments—most notably, the initial steps to implement PAMA; but it also included the repeal of the dreaded Sustainable Growth Rate. The Centers for Medicare & Medicaid predicts the 2016 Physician Fee Schedule final rule, the first physician fee schedule issued since the SGR repeal, brings some silver linings with a positive impact on payment to pathologists and independent laboratories, 8% and 9% respectively. CMS predicts that for pathology, work relative value units (RVU) changes and Practice Expense RVU changes will each have a 4% positive impact. For independent laboratories, CMS predicts a 1% impact due to Work RVU changes and a 7% positive impact due to Practice Expense RVU changes. CMS indicates the 1% and 7% don’t precisely equal the 9% predicted due to rounding.
In evaluating the practice expense and work RVUs for pathology services, CMS discussed the potential impact of block numbers and batch size on those expenses. CMS proposed standard times for certain clinical labor activities related to pathology services and stated it believed certain activities require the same time commitment regardless of the service they are performed in connection with and regardless of the number of blocks or the batch sizes involved.
For more coverage of the physician fee schedule, click here for the full version of this article originally published in the Nov. 12, 2015 issue of National Intelligence Report.