Despite the passage of the Continuing Appropriations Act of 2014, the Medicare Physician Fee Schedule (MPFS) for 2014 will likely be delayed due to furloughs and a shift in priorities away from policy and rulemaking by the Centers for Medicare & Medicaid Services (CMS) during the government shutdown.
The annually published rules include regulations and rates for services provided by all health care providers for Medicare Part B beneficiaries. The rules are normally released November 1 for January 1 implementation, allowing Medicare contractors and providers approximately 2 months to make the necessary changes in coding and billing systems. Significant for audiologists and speech-language pathologists this year are anticipated changes to the Physician Quality Reporting System and the publication of Medicare rates for the four new Current Procedural Terminology (CPT© American Medical Association) codes that were created to replace CPT Code 92506 (Evaluation of speech, language, voice, communication, and/or auditory processing), effective January 1, 2014.
As soon as possible after release of the 2014 MPFS, ASHA's health care economics and advocacy staff will notify members, through ASHA Headlines and our website, of publication and analysis of the schedule.
The MPFS cycle is repeated annually with the release of proposed rules and rates in July with a 60-day comment period, publication of the final rules in November, and implementation on January 1. The proposed rules are often driven by legislative mandates or necessary programmatic changes, and the final rule includes regulations and rates. Audiology and speech-language pathology services under Medicare Part B (outpatient) have reimbursement rates established by the MPFS. ASHA analyzes the proposed rule, works with CMS officials to submit comments on behalf of audiologists and speech-language pathologists, analyzes the final rule, submits a response, and updates webpages and resources for members providing services to Medicare Part B beneficiaries.
For more information, please contact Mark Kander, ASHA's director of health care regulatory analysis, at [email protected]; Lisa Satterfield, ASHA's director of health care regulatory advocacy, at [email protected]; or Neela Swanson, ASHA's director of health care coding policy, at [email protected].