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Proposed Medicare Physician Fees' Winners and Losers

Cheryl Clark, for HealthLeaders Media, July 15, 2013

Some of the biggest cuts are aimed at independent testing laboratories, which see 26% of their fees slashed, followed by radiation therapy centers, which may lose 13% under CMS's "particularly complicated," proposed changes.

The proposed rule governing next year's physician fee schedules released last week by the Centers for Medicare & Medicaid Services clearly show the winners and losers in primary care and specialty physician paychecks starting Jan. 1.

Anesthesiologists, emergency room physicians, cardiologists, cardiac surgeons, critical care specialists, geriatricians, infectious disease specialists, and thoracic surgeons seem to be the winners, with upgrades in code payments that average 2% or 3%.

Family practitioners, gastroenterologists, general surgeons, internists, nephrologists, neurosurgeons, nuclear medicine specialists, and pulmonary disease specialists all would get a 1% average increase, depending on which codes they most frequently bill.

But doctors who work with radiation therapy and cancer appear to be getting cuts. And some of them, depending on the codes they traditionally bill and the settings in which they work, in a hospital outpatient department or in a private practice office, will be getting large cuts.

Some of the biggest cuts are aimed at independent testing laboratories, which because of proposed new way of calculating clinical laboratory fee stand to see 26% slashed, followed by radiation therapy centers, which may lose 13%, largely because of the way CMS proposes to calculate the relative value unit portion of that pay.

For individual practices, specialists in pathology and radiation oncology would absorb the biggest average cuts of 5%, while interventional radiologists would get cut 4%; allergy and immunology practitioners, rheumatologists would receive 3% less. 

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