Methods of Participation: Currently, there are two ways an eligible professional may participate in the Physician Quality Reporting System: (1) Individual eligible professional or (2) Group practice reporting option (GPRO) – single tax ID with 2 or > eligible providers (EP). 2010 – a GPRO was 200+ EP 2011 a GPRO was 200+ and a [...]

The proposed rule adds a Health Risk Assessment (HRA) as a required element for the annualwellness visit (AWV) beginning in 2012. Regulations for Medicare coverage of the AWV are established at 42 CFR 410.15. The AWV maybe performed by a physician, nonphysician practitioner (physician assistant, nurse practitioner,or clinical nurse specialist), or a medical professional (including [...]

Medicare has a longstanding policy to reduce payment by 50 percent for the second andsubsequent surgical procedures furnished to the same patient by the same physician on thesame day. Effective January 1, 1995, the MPPR policy, with the same percentage reduction,was extended to nuclear medicine diagnostic procedures. Under the CY 2006 PFS, the MPPRpolicy was [...]

And yes, there will be changes in valuation of RVUs. 2012 Practice expense RVUs are in thethird of a four-year transition. Work RVUs are in the fourth of an every-five year review andsome adjustments could be applied here as well. The application of a budget neutrality adjustment may also affect RVUs. Budget neutralitytypically requires that [...]