CMS finalizes 2005 physician reimbursement rate

January 1, 2005

As of January 2005, physicians will see a 4% increase in aggregate spending under the 2005 fee schedule for physicians, according to the Centers for Medicare & Medicaid Services. The spending increase includes a 1.5% reimbursement raise for physicians, as mandated by Congress to prevent a previously planned cut in payment rates by 3.3% this year. In addition, CMS has authorized higher payments for certain preventive services.

As of January 2005, physicians will see a 4% increase in aggregate spending under the 2005 fee schedule for physicians, according to the Centers for Medicare & Medicaid Services. The spending increase includes a 1.5% reimbursement raise for physicians, as mandated by Congress to prevent a previously planned cut in payment rates by 3.3% this year. In addition, CMS has authorized higher payments for certain preventive services.

For one, physicians can bill and receive separate payment for a new beneficiary's first physical and screening electrocardiogram. They can also receive payment for a more extensive office visit if they provide medically necessary care on the same day as the physical.

In addition, physicians will receive increased payments for vaccinations and other types of injections, even when these services are provided on the same day as other Medicare-covered services. Moreover, CMS says that it has implemented recommendations from the American Medical Association that will result in payment rates for drug administration services that are 120% higher than they were in 2003.