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MGMA 2014 Proposed Medicare Physician Fee Schedule Analysis


The Centers for Medicare & Medicaid Services (CMS) published the proposed 2014 Medicare fee schedule for physician services on July 8, 2013. As a member benefit, MGMA provides a comprehensive analysis of the 2014 Medicare physician fee schedule proposed rule. The analysis walks members through proposed changes to Medicare physician payments and incentive programs for next year. Among others, some of the proposals covered in the analysis include:      

  • An approximate 24.4 percent physician payment cut due to the sustainable growth rate formula (SGR)   
  • Implementation of the physician value-based payment modifier by applying the 2016 modifier to groups of 10 or more eligible professionals (EPs) and requiring large groups to assume risk through the quality-tiering component of the program   
  • Changes to the Physician Quality Reporting System (PQRS), such as requiring EPs to report at least nine measures covering at least three of the National Quality Strategy Domains and adding a new “qualified clinical data registry” reporting method to the program   
  • Limitations to the payment for approximately 200 services where the physician fee schedule nonfacility payment is higher than the total payment to furnish the same service in a facility setting (either a hospital outpatient department or an ambulatory surgery center)

CMS will accept public comments on the proposed rule until Sep. 6, and plans to issue a final rule by Nov. 1. MGMA will submit our formal comments on the rule soon, and share them with our membership through the Washington Connexion.


Copyright 2013. MGMA-ACMPE. All rights reserved. 2014 Proposed Medicare Physician Fee Schedule Analysis Exclusively for MGMA-ACMPE Members.


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