Physician Pay Wars' Winners and Losers

Amanda Becker, director of medical economics and quality for the American Academy of Neurology, says the neurologists' 7% fee cut is coming chiefly from reductions in payment for electromyology (EMG) and nerve conduction studies, because of coding changes for those services. She says that of the AAN's members, 38% indicated in a recent survey that EMG is a primary focus in their practices.

"It will really depend on what kind of a practice a neurologist has how much of a pay cut they'll see," Becker says. "Physicians who mainly do a lot of evaluation and management (E&M) may not see much of an impact."

The groups opposed to what they see as excessive pay cuts are concerned that the reductions will come on top of the statutory 26.5% across-the-board cut known as the sustainable growth rate (SGR) formula, which is set to kick in January 1 for more than one million physician and non-physician practitioners.

CMS officials, however, said in a statement, that they don't think the SGR will take effect, at least not with that severe of a cut.

"Congress has overridden the required reduction every year since 2003," the statement said. "The Administration is committed to fixing the SGR update methodology and ensuring these payment cuts do not take effect. Predictable, fiscally-responsible physician payments are essential for Medicare to sustain quality and lower health care costs over the long term."