CMS Announces 2011 Medicare Premiums, Coinsurance, and Deductibles
The Centers for Medicare and Medicaid Services (CMS) announced on November 4, 2010, the 2011
Medicare Part A and Part B premium, deductible, and coinsurance amounts to be paid by Medicare
beneficiaries. The standard monthly Medicare Part B premium will increase to $115.40 in 2011; however, "hold harmless" provision in the current law will protect 73% of beneficiaries from the increase. These beneficiaries will pay the same $96.40 monthly premium they have paid since 2008. The Part B deductible will increase to $162 in 2011, up from $155 in 2010. Higher-income beneficiaries (those with incomes over $85,000 single/$170,000 married) will pay higher premiums.
The Medicare Part A deductible for 2011 will increase to $1,132, up from $1,100 in 2010. The Part A deductible is paid by the beneficiary per "spell of illness" for covered inpatient hospital services. After the first 60 days of hospitalization, the 2011 coinsurance will be $283 per day for days 61 through 90 ($275 in 2010), and $566 per day ($550 in 2010) for the 91st and later days. The daily coinsurance for the 21st through 100th day in a skilled nursing facility will be $141.50 in 2011, up from $137.50 in 2010.
Thursday, April 7, 2011
Medicare physician fee schedule - Quick overview
Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download
covered services and their payment rates. Physicians’ services include the following:
* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.
Medicare Physician Fee Schedule Payment Rates
Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)
Medicare Physician Fee Schedule Payment Rates Formula
The Medicare PFS payment rates formula is shown below:
[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF
Medicare fee schedule download

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