JACKSON, Mich.--(BUSINESS WIRE)--Anesthesia Business Consultants (ABC), a leading provider in billing and practice management for the anesthesia and pain management specialties, shares important developments regarding CMS’ publishing the Proposed and Final Medicare Fee Schedule Rules payment updates. CMS chose to say nothing about payment rates for 2015 in the Proposed Rule that appeared on July 3rd, because the Fee Schedule update and Sustainable Growth Rate (SGR) “calculations are determined under a prescribed statutory formula that cannot be changed by CMS.” (CMS Fact Sheet on Proposed policy and payment changes to the Medicare Physician Fee Schedule for Calendar Year 2015.) Instead, the current conversion factors will remain unchanged through March 2015, pursuant to the Protecting Access to Medicare Act (PAMA) of 2014. Before Congress passed PAMA, CMS had estimated the update 2015 at -20.9 percent. That is still a reasonable approximation—unless, as everyone hopes, the SGR is repealed or at least suspended again by legislation.

The Final Fee Schedule Rule published last November and effective on January 1, 2014 reduced the relative value units (RVUs) for the four interlaminar epidural injections identified by CPT® codes 62310, 62311, 62318 and 62319. CMS was bombarded with thousands of comment letters criticizing the decision to use values lower than those recommended by the AMA-Specialty Society Relative Value Update Committee (RUC). In response, the Agency has announced its intention to re-examine the “interim final” values assigned to the four injections in last year’s Final Rule.

CMS has proposed to delete the PQRS code reported the most commonly by anesthesiologists: Measure #30, Timely Administration of Antibiotic Prophylaxis, among other measures. The Anesthesia Quality Institute’s (AQI’s) National Anesthesia Clinical Outcomes Registry (NACOR), which was designated a Qualified Clinical Data Registry (QCDR) earlier this year, will likely become even more attractive as a method of participating in PQRS, given that it has defined 11 quality measures that supplement the official PQRS measures, if the proposed deletions are finalized. (See our Alert Reporting PQRS Measures: Anesthesiology's Own Quality Clinical Data Registry (QCDR) dated June 16, 2014.)

The criteria for satisfactory reporting by individual eligible professionals are generally similar to the criteria in effect for the 2014 PQRS incentive (report on at least nine measures from three different domains for at least 50 percent of patients; measures with a 0 percent performance rate would not be counted). One proposed innovation would be a requirement that eligible professionals who see at least one Medicare patient in a face-to-face encounter and choose to report PQRS quality measures via claims and registry would be required to report on at least two measures in a newly-proposed set of PQRS cross-cutting measures (Proposed Rule Table 21, pp. 308-314).

CMS is now receiving public comments on the Proposed Rule; the comment period will close on September 2, 2014. The Final Rule is expected to be posted around the 1st of November.

About Anesthesia Business Consultants

ABC, established in 1979, is the nation’s largest billing and practice management company dedicated to the complex and intricate specialty of anesthesia and pain management. ABC is the developer of the premier perioperative anesthesia platform, OneSourceAnesthesia, the mobile systems architecture that supports the entire perioperative process. OneSourceAnesthesia provides patient portals, pre-admission testing tracking, intra-operative documentation, and anesthesia quality measures tracking. Our revolutionary F1RSTUse secures the benefits of Meaningful Use through complete EHR. The heart of our offerings is ABC’s proprietary practice management software, F1RSTAnesthesia™. ABC’s newest tool, F1RSTAnalytics™ offers data prowess, providing the data to aid in operating your anesthesia practice as an effective clinical organization and successful business. Our solutions provide accurate, prompt and complete billing and revenue cycle management. Our exclusive focus improves your cash flow and profitability. Visit ABC at: www.anesthesiallc.com.