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CMS: 21% decrease in MPFS payments starting April 15th, 2015

Important Information Regarding the 2015 Medicare Physician Fee Schedule

21% decrease for MPFS payments beginning April 15th for claims starting with DOS April 1, 2015

On April 1, 2015, the Medicare Physician Fee Schedule (MPFS) was updated using the Sustainable Growth Rate (SGR) methodology as required by current law. The SGR methodology required a 21% decrease in all MPFS payments beginning April 1, 2015. CMS held claims paid under the MPFS with dates of service on and after April 1, 2015 to  limit the impact on Medicare providers and beneficiaries.

Beginning on April 15th, 2015, CMS will begin paying held MPFS claims at the reduced rate, based on the negative update. CMS will release one day’s worth of held claims, processing and paying at the rate that reflects the negative update. To provider a continuing cash flow to providers, CMS will also hold the receipts for that day, thus, continuing to hold 10 days’ worth of claims in total.

Claims for services furnished on or before March 31, 2015 are not affected by the payment cut. No action is necessary from providers who have already submitted claims for the impacted dates of service.

For questions please contact CMS.

Information obtained from: