Medicare Physician Payment Rates Receive Temporary Extension
American Academy of Sleep Medicine
Friday, March 5, 2010
Late in the evening on March 2, the Senate voted 78-19 to pass HR 4691, the "Temporary Extension Act of 2010," which was signed into law by President Obama on March 2. It includes provisions to extend 2009 Medicare physician payment rates through the end of the month. As a result, the 21 percent payment cut that took effect on March 1 has been postponed until April 1. Discussions are still underway in the House and Senate on the next steps that will be taken to address the Medicare payment crisis. Proposals are being circulated for another short-term patch to the sustainable growth rate (SGR) formula.
Effective immediately, claims with dates of service March 1 and later that were being held by Medicare contractors will be released for processing and payment. The statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims). In addition, the new law extends through March 31, 2010, the exception process for therapy claims reaching the annual cap, retroactive to Jan. 1, 2010. Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service Jan. 1 through March 31, 2010, using the KX modifier, following the pre-Jan. 1, 2010, requirements for therapy cap exceptions.