Updated December 5, 2013
The Centers for Medicare and Medicaid Services released the final 2014 Physician Fee Schedule (PFS) Rule and the Hospital Outpatient Payment Rule.
CAP has been meeting with CMS and the White House to lay out our specific concerns. On September 6, CAP submitted formal comment letters to CMS:
CAP has also engaged with the AMA and other affected organizations to strengthen our response efforts. As the Congress considers legislation to repeal the Sustainable Growth Rate (SGR), CAP is engaged in finding alternative ways for pathologists to meet quality and pay for performance requirements.
- CAP opposes this new round of cuts to pathologists and pathology practices.
- CMS’ proposal to link payment for pathology services to rates paid in the hospital outpatient prospective payment system is particularly concerning.
- The proposed policy fails to take into consideration the technical costs associated with specific individual codes.
- Further, it fails to recognize the distinct costs of physician services, which are required by law to be based on the resources required to perform the service.
- CAP supports the existing AMA-RUC process for valuing physician service codes. This process involves many stakeholders, including CAP.
- The AMA-RUC has shown itself to be accurate and fair, and has been thoroughly vetted over many years.
- CAP remains concerned about CMS’ implementation of the Physician Quality Reporting System. CAP proposed three new quality measures for pathologists, which CMS rejected.
The 2014_Physician Fee Schedule Final Rule Impact Table
(Excel, 176 KB)
Change in APC Payment Rates for Select Pathology Services
(PDF, 110 KB)
CMS Halts Plan to Cap Pathology Payments to APC Rates, Payment for Other Key Services is Reduced
November 27, 2013 (PDF, 40 KB)
CMS Halts Plan to Cap Pathology Payments to APC Rates, Payment for Other Key Services Reduced
November 27, 2013
- Pathology Cuts Letter to CMS,
October 17, 2013 (PDF, 31 KB)
- Cancer Leadership Comments to CMS on Physician Fee Schedule,
September 6, 2013 (PDF, 31 KB)
- Sidley Austin Memo on Proposed Rule (CMS-1600-P),
September 4, 2013 (PDF, 394 KB)
- 40 Medical Organizations Sign-on to Letter Addressing the CMS Proposal to Cap Payment in Physician Offices at Facility Levels, August 29, 2013 (PDF, 335 KB)
- CAP Advocacy Action Alert, August 27, 2013 (PDF, 165 KB)
- After Claims Denied, CMS Revises Technical Component of
Pathology Services, August 26, 2013
- CAP Joins Other Pathology, Laboratory and Diagnostics Industry Groups In Opposing CMS Physician Fee Schedule Proposed Rule for CY 2014, August 23, 2013
(PDF, 139 KB)
- CAP Advocacy Action Alert, August 13, 2013 (PDF, 165 KB)
- CAP Advocacy Action Alert, August 6, 2013 (PDF, 153 KB)
- Issue Brief: Medicare Payment for Pathology Services, (PDF, 131 KB)
- Letter opposing the physician fee schedule cuts and asking Congress to intervene signed by major pathology organizations and state pathology societies July 31, 2013 (PDF, 18 KB)
- CAP Advocacy Action Alert, July 30, 2013 (PDF, 104 KB)
CAP Advocacy Action Alert, July 19, 2013
View the CMS 2014 Physician Fee Schedule Webinar.
A recording of the Dec. 4 CMS Physician Fee Schedule webinar is now available online. The 90-minute webinar features CAP leaders explaining the changes announced by CMS regarding the final 2014 Physician Fee Schedule (PFS) rule released on Nov. 27, which contains reimbursement changes affecting pathologists. Learn about the final rule’s pathology-related details, the impact on pathologists and CAP’s advocacy efforts around these issues. The webinar also includes a Q & A with the CAP’s staff and members.