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Medicare >> Memorandum
To: 2010 Medicare Part B Fee Schedules (January 1, 2010 through November 30, 2010) 
From: AHCA Members
Subject: 2010 Medicare Part B Fee Schedules (January 1, 2010 through November 30, 2010)
Date: 7/7/2010

The information provided in this memo covers the periods of January 1, 2010 through May 31, 2010, and June 1, 2010 through November 30, 2010.

2010 Medicare Part B Fee Schedules – Effective June 1, 2010 through November 30, 2010

The June 1, 2010 therapy fees for each CPT/HCPCS in each geographic area are provided in Excel format.  This document has three worksheets containing the following information:

  1. The 2010 Medicare Part B Fee Schedule (Part B Fees) for Outpatient Rehabilitation for each Carrier and Locality.
  2. The 2010 Relative Value Units (RVUs) for each Outpatient Rehabilitation Therapy Code.
  3. The 2010 Geographic Practice Cost Indices (GPCI) by Medicare Carrier and Locality.

The final Part B Fee Schedule amount is calculated as follows:

(A1 x B1) + (A2 x B2) + (A3 x B3)) x Conversion Factor, where:  

A1 = Physician Work RVU
A2 = Non-Facility Practice Expense RVU
A3 = Malpractice RVU
B1 = Work GPCI
B2 = Practice Expense GPCI
B3 = Malpractice GPCI

Conversion Factor = $36.8729

These fees reflect a change in the conversion factor as a result of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which President Obama signed into law on June 25, 2010.  This legislation provides for a 2.2 percent update to the 2010 Medicare Physician Fee Schedule (MPFS), effective for dates of service June 1, 2010, through November 30, 2010.  (Revised payment files were posted by CMS on July 1, 2010.)

2010 Medicare Part B Fee Schedules – Effective January 1, 2010 through May 31, 2010

The January 1, 2010 therapy fees for each CPT/HCPCS in each geographic area are provided in Excel format.  This document has three worksheets containing the following information:

  1. The 2010 Medicare Part B Fee Schedule (Part B Fees) for Outpatient Rehabilitation for each Carrier and Locality.
  2. The 2010 Relative Value Units (RVUs) for each Outpatient Rehabilitation Therapy Code.
  3. The 2010 Geographic Practice Cost Indices (GPCI) by Medicare Carrier and Locality.

The final Part B Fee Schedule amount is calculated as follows:

(A1 x B1) + (A2 x B2) + (A3 x B3)) x Conversion Factor, where:  

A1 = Physician Work RVU
A2 = Non-Facility Practice Expense RVU
A3 = Malpractice RVU
B1 = Work GPCI
B2 = Practice Expense GPCI
B3 = Malpractice GPCI

Conversion Factor = $36.0791

On May 10, 2010 CMS released revised physician payment files to Medicare Contractors necessary to reflect changes to payments as a result of the CY 2010 correction notice published in the Federal Register on May 11, 2010 and changes resulting from the Patient Protection and Affordable Health Care Act.  This fee schedule also reflects the Department of Defense Appropriations Act of 2010, the Temporary Extension Act of 2010, and the Continuing Extension Act of 2010 which have provided for a zero percent update to the 2010 Medicare Physician Fee Schedule and is effective for claims with dates of service from January 1, 2010 through May 31, 2010.  Instructions regarding the reprocessing of claims paid prior to the implementation of the revised files is forthcoming from CMS.

The 2010 Medicare Physician Fee Schedule Final Rule was published in the Federal Register on November 25, 2009 and initial corrections were published in the Federal Register on December 10, 2009.

An overview of the Physician Fee Schedule Payment Policies may be found at http://www.cms.hhs.gov/PhysicianFeeSched/ and an overview of skilled nursing facility consolidated billing and annual updates can be found at http://www.cms.hhs.gov/SNFConsolidatedBilling/.

Please note:  A new Medicare Physician Fee Schedule will be required for dates of service beginning December 1, 2010.

Special thanks to Mr. Tony Marshall of the Florida Health Care Association for calculating these fees for each geographic area.

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