Thursday, June 30, 2011

Avoiding e-prescription fine payment from Medicare

Do you want to avoid the 1% Medicare Part B payment adjustment on claims in 2012?

*  Send at least 10 e-prescriptions for Medicare Part B patient visits which include one of the e-prescribing denominator codes*

AND

*  Send your 10 claims to Medicare Part B with the denominator code* and code G8553 before 6/30/2011
OR

* Send one (1) claim to Medicare Part B with the denominator code and one of the Hardship codes before 6/30/2011


G8642: The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act

G8643: The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act

G8644: the eligible professional does not have prescribing privileges
Labels:

0 comments:

Post a Comment

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