11/18/2021 2020 Part B Utilization Data Loaded
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January 2022
October 2021

CMS Transmittals

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Changes in 2003 Physician Fee Schedule

CMS previously published a final physician fee schedule rule for 2003 on December 31, 2002. This rule resulted in an average reduction in payment rates of 4.4%. At the time of publication, CMS administrator Tom Scully stated that CMS believed the formula used to set the rates was flawed, but that CMS lacked the legal authority to make the required corrections.

On February 13, Congress passed the Consolidated Appropriations Resolution 2003 (CAR) that authorizes CMS to fix the formula. The result will be a 1.6% update to the Physician Fee Schedule effective March 1, 2003. Prior to March 1, claims have been paid at the 2002 rate.

The bottom line on this change is that the multiplier used to determine physician fees for 2003 pathology and radiology procedures will be $36.7856 per Relative Value Unit (RVU) instead of the originally published $34.592 per RVU. Last year the multiplier was $36.1992 per RVU; thus, physicians get 59 cents more, on average, per RVU this year than last.

If you submit physician charges AFTER March 1 for services performed BEFORE March 1, you will ....

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