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Focus on Healthcare: CMS Issues Proposed Changes to Medicare Physician Fee Schedule

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The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 8, 2015, updating payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for calendar year 2016.
August 21, 2015

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on July 8, 2015, updating payment policies, payment rates and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) for calendar year 2016.

This is the first PFS proposed rule since the repeal of the Sustainable Growth Rate (SGR) formula by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

CMS has proposed changes resulting in increases for some specialties and decreases for others. Table 45 published in the Federal Register, volume 80, number 135 on July 15, 2015, shows the estimated impact by specialty. Notable increases include 9% for independent laboratories and 8% for pathology. Specialties showing a decrease include 5% for gastroenterology, 3% for radiation oncology and 9% for radiation therapy centers.

Additional information on the proposed changes can be found on the CMS website here.

CMS is accepting public comments on the 2016 PFS proposed rule until September 8, 2015. The final rule will be issued by November 1, 2015.

 

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