Medicare Payments

The AAN is very pleased with the inclusion of advance care planning codes in the 2016 Medicare Physician Fee Schedule proposed rule. The AAN has continuously advocated for this coverage and was a part of the process to define and value these codes.

2016 Physician Fee Schedule
2015 Physician Fee Schedule

Medicare fee for service claims with dates of service or dates of discharge on or after April 1, 2013, will incur a two-percent reduction in Medicare payment.

Claims for durable medical equipment (DME), prosthetics, orthotics, and supplies, including claims under the DME Competitive Bidding Program, will be reduced by two percent based upon whether the date of service, or the start date for rental equipment or multi-day supplies, is on or after April 1, 2013.

Beneficiary payments for deductibles and coinsurance are not subject to the two percent payment reduction BUT Medicare's payment to beneficiaries for unassigned claims is subject to the cut.

The sequestration, resulting from the Budget Control Act of 2011, was postponed by the American Tax Payer Relief Act of 2012. The two percent Medicare cut is part of broader cuts, including automatic spending cuts to national defense and other non-defense budget, to eliminate a total of $1.2 trillion from the federal budget over the next decade.

Read the FAQ on Sequestration from the American Medical Association.


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