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Capitol Health Call
October 14, 2009

Medicare Physician Payments

JAMA. 2009;302(14):1522. doi:10.1001/jama.2009.1457

A Government Accountability Office (GAO) report released on August 31 calls for the Centers for Medicare & Medicaid Services (CMS) to ensure that physician fees reflect efficiencies that commonly occur when services are provided at the same time (http://www.gao.gov/new.items/d09647.pdf).

The report noted that the CMS had implemented a “multiple procedure payment reduction” policy for certain imaging and surgical services when 2 or more related services are given together (such as reading 2 computed tomography scans of a patient and being reimbursed twice for the prior medical history review component). This policy produced savings of about $96 million in 2006 for imaging services. The GAO said expanding the policy to reflect the actual work performed by physicians involving certain imaging services could reduce these payments by an additional $175 million annually.

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