Economic Implications of Medicare's Rule Change for EP's

I just got back from a meeting with our business manager and I'm depressed.

We did some homework regarding the implications of the new Medicare payment rules for our procedure codes no longer being exempt from the "51 modifier" as I mentioned before.

Well, it's huge.

We applied this rule change to last year's billings to determine the impact. Assuming we used the same codes and applied to new rule to Medicare patient's, the drop in the physician portion of Medicare reimbursement will be 18.76% for our procedural compensation. Nearly 20%. Ouch.

Now I have no idea how the technical portion of Medicare payments will be affected. Usually technical payments exceed physician payments 10 to 1. No doubt their cut will be considerable too. But suffice it to say, doctors have a lot less "wiggle room" to their income these days than do hospitals. Yet physician revenue remains an easy target. Our political lobbying is dwarfed by other, better connected, entities. And Medicare is a fixed pot of funds which must be distributed to the masses. Certainly, CMS has found a creative way to implement income redistribution.

But if I were a patient, I'd like to see my doctor, the one doing the procedure, get compensated appropriately for their skill and expertise - the last thing I'd want is a doctor pissed that his time and skill weren't worth the effort to perform my procedure anymore. I'd like to know how much this pay cut will effect the hospitals and insurance companies who continue to demonstrate record-setting revenues.

-Wes

10:46 CST - Addendum: Oh, I forgot: this revenue cut does not include CMS's already-threatened 10.1% physician revenue cuts. Could this mean nearly 30% cut in EP's revenue? If so, the implications for our senior citizens could be profound.