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Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013

Publication: Federal Register

This proposed rule would update the payment rates under the Medicare Physician Fee Schedule for Part B drugs and other Part B services based on national uniform relative value units (RVUs).  The rule also proposes implementing the Affordable Care Act by requiring a face to face encounter as a condition of payment for durable medical equipment(DME) items.  In order to implement the Middle Class Tax Relief and Jobs Creation Act (MCTRCA), the rule proposes new claims data reporting requirements for therapy services. 

Additional components of the rule propose to:

  • Eexpand telehealth services
  • Primary care and care coordination services
  • Part B drug payment rate updates

The rule also proposes updates to the:

  • Physician Compare website
  • Physician Quality Reporting System
  • Electronic Prescribing Incentive Program
  • Medicare Shared Savings Program

View full text of rule