Medical Billing Blog

SGR Update: SGR Patch/ICD-10 Delay Passed

Posted by Scott Shatzman on Tue, Apr, 01, 2014 @ 07:04 AM

US Capitol Building at Night Washington DC 1 CK3BYZD5Q6 1600x1200 resized 600The United States Senate has joined the House of Representatives and passed legislation to prevent a 24% cut in physician fee schedule payments from occurring today as previously scheduled.  Instead, Medicare physician fee schedule payments will continue to be paid as they have been for the past 3 months.   Although the legislation must be signed by the President in order to become effective, the President has indicated that he will sign this legislation once it reaches his desk. 

The so-called SGR Patch approved by Congress will be in effect for 12 months, expiring on March 31, 2015.  Between now and then, Congress will have to enact a permanent fix or enact another patch to prevent a huge drop in Medicare Physician payments next April 1. 

In addition to preventing the SGR related reduction, Congress approved language extending various other Medicare provisions slated to expire at Midnight tonight.  These include:

  • Extends Medicare work Geographic Practice Cost Index (GPCI) floor for 1 year

  • Extends Medicare therapy cap exception process for 1 year

  • Extends Medicare ambulance add-on payments for 1 year

  • Extends Medicare adjustment for Low-Volume hospitals for 1 year

  • Extends Medicare-dependent Hospital (MDH) program for 1 year

In addition to these “extenders” Congress also approved a one-year delay in the effective date of the ICD-10 transition.  As you know, ICD-10 has been scheduled to take effect on October 1, 2014.  Due to Congressional intervention, the new effective date will be October 1, 2015. 

Thanks to the GR Committee at the HBMA for contributing this piece.