CODING AND REIMBURSEMENT | Updates to the Medicare Physician Fee Schedule for 2018

By Kate Thomas

This article is a part of the January/February 2018, Volume 30, Number 1, Audiology Today issue.

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule (MPFS) final rule for 2018. The final rule addresses adjustments to the MPFS and other Medicare Part B payment policies, including changes in valuation for services and overall payment updates.

The changes finalized in the MPFS final rule officially took effect on January 1, 2018. The Academy has prepared a list of payment rates by CPT code for audiology procedures covered under the fee schedule. This list is available on the Academy's website, search key words "Final Rule Changes to 2018 Medicare Physician Fee Schedule." The Academy has also prepared an analysis of the final rule below, and will continue to provide additional information and updates on the Reimbursement page of the Academy's website.

CMS Finalizes Conversion Factor of $35.99 for CY 2018

For Calendar Year (CY) 2018, CMS determined the MPFS conversion factor to be $35.99. This update reflects the +0.50 percent update established under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, reduced by 0.09 percent, due to the misvalued code target recapture amount, required under the Achieving a Better Life Experience (ABLE) Act of 2014. The conversion factor for CY 2018 represents a slight increase over the conversion factor for CY 2017, which was $35.89.