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Updated December 3, 2012

Confronting New Medicare Payment Realities Part 1: How 2013 Reimbursement Changes Will Impact Pathologists

CMS’s 2013 final Physician Fee Schedule (PFS) is now out and contains significant changes for pathologists. Although the agency raised the professional component (PC) of the surgical pathology code 88305 by 2%, it lowered the technical component (TC) by 52%, beginning Jan. 1. This change also altered 88305’s global payment, decreasing it by 33% as a result of this revaluation. The final rule also placed the newly developed molecular pathology CPT codes on the Clinical Laboratory Fee Schedule (CLFS) while creating a new CMS HCPCS II G-code for situations requiring physician interpretation and reporting of these tests for Medicare beneficiaries. Presentations are also available (PDF, 114 K).

Speakers:

  • Moderator: Richard Friedberg, MD, PhD, FCAP,Chair, CAP Council on Government and Professional Affairs
  • Speaker: Jonathan L. Myles, MD, FCAP, Chair of CAP’s Economic Affairs Committee

Confronting New Medicare Payment Realities Part 2: What CAP Members Need to Know about 2013 PQRS Changes

Next year’s CMS Physician Quality Reporting System (PQRS) includes numerous changes for all providers, including pathologists. Most notably, pathologists who participate successfully in 2013 will be incentivized, while those participating unsuccessfully (or not participating) will be penalized in 2015.

Part 2 in this two-part Webinar series will focus on how PQRS changes—including new group reporting options—and the implementation of the value-based modifier beginning next year will impact pathologists. Presentations are also available (PDF, 1.3 MB).

Speakers:

  • Moderator: Jonathan L. Myles, MD, FCAP, Chair of CAP’s Economic Affairs Committee (EAC)
  • Speaker: Emily Volk, MD, PhD, FCAP, Chair, EAC Measures and Performance Assessment Workgroup

Thriving in an ACO: How Pathologists Can Confront Challenges and Maximize Opportunities

ACOs offer both challenges and opportunities for pathologists. The CAP Policy Roundtable’s recently released White Paper, Contributions of Pathologists in ACOs: A Case Study, is an important resource for College members during this time of great change in health care delivery.

Watch and listen to one of the CAP members featured in the White Paper, David Scamurra, MD, FCAP, of Catholic Health in western New York, discuss how his team is developing pathology-related performance measures to improve quality and cost efficiency. Also hear White Paper author David J. Gross, PhD, CAP’s Policy Roundtable Director, discuss his research findings. Presentations are also available (PDF 435 K).

Anticipating Reimbursement Adjustments: Hear CAP Experts Discuss Expected Payment Changes in 2013

Reimbursement for certain pathology services may be reduced beginning in January 2013, as CMS previously announced plans to focus on revaluing certain high volume anatomic pathology codes as required by the health care reform law. Reimbursement changes to the technical component (TC) of the surgical pathology code family (88300-88309) are expected to be announced in November when CMS releases the Final Physician Fee Schedule for calendar year 2013.

Hear CAP experts discuss what’s driving these changes, the College’s Advocacy efforts relating to reimbursement, and what these changes could mean for CAP members.

Investigating the Impact of Self Referral: More Tests, Higher Costs, and Fewer Cancer Detections

Watch a replay of a Webinar with study author, noted Georgetown economist Dr. Jean Mitchell. Please note: The audio is delayed by 2-3 seconds. (To view in full-screen, click on the bottom right corner.)

Understanding CMS PQRS New Pathology Measures: How CAP Members Can Participate

Watch a replay of the December 7 webinar: “Understanding CMS PQRS New Pathology Measures: How CAP Members Can Participate”.

Molecular Pathology Physician Work Survey

Watch a replay of the August 3 webinar: “Molecular Pathology Physician Work Survey”.

Carrier Advisory Committee Roles and Representation

Watch a replay of the May 26 webinar: “Understanding Medicare’s Local Coverage Determinations: A Primer for CAP Members”.

   
 

 

   
 
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