CMS warns that updated payment rates may not be posted yet
American Academy of Sleep Medicine
Thursday, January 17, 2013
In a Jan. 3 response to enactment of the American Taxpayer Relief Act, the Centers for Medicare & Medicaid Services (CMS) indicated that some carriers may not post updated 2013 Medicare physician payment rates and limiting charges until later in the month. The new law provides for a zero percent update for claims with dates of service on or after Jan. 1, 2013, through Dec. 31, 2013. Claims with dates of service prior to January 1, 2013, are unaffected. Medicare claims administration contractors will be posting the payment rates on their websites no later than Jan. 23, 2013.
By law, Medicare is required to pay physicians the lesser of the submitted charge or the Medicare approved amount. To avoid having Medicare payments cut, physicians should not base billed charges on the previously posted 2013 Medicare fee schedules. Instead, you should either charge the 2013 retail rates or defer submission of claims for 2013 dates of service until the new 2013 rates are published.