2013 Payment Policy and Coding Changes Affecting Surgical Practice

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Several changes to payment policy and coding and reimbursement are set to take effect in 2013. One catalyst for these changes is the calendar year (CY) 2013 Medicare physician fee schedule (MPFS) final rule, which the Centers for Medicare & Medicaid Services (CMS) released in November 2012. The fee schedule lists payment rates for Medicare Part B services and is updated annually. The American College of Surgeons (ACS) submitted comments related to the MPFS proposed rule on August 31, 2012, which indicated how policy changes could either positively or adversely affect physician payment rates.

Concurrently, the American Medical Association (AMA) released Current Procedural Terminology (CPT*) code changes and revisions for 2013 that will be used by physicians and other qualified health care professionals as a guide to appropriately code for services rendered to patients.

Although the MPFS and coding changes introduce several important payment and coding policies that will affect all physicians, this article focuses on updates particularly relevant to surgery and other related specialties starting in 2013, beginning with highlights from the MPFS.