On January 8, 2004, the Government Printing office published the Centers for Medicare and Medicaid (CMS) 2004 physician fees. The fee schedule applies to Medicare services under the fee-for-service program, but not Medicare+Choice or Medicaid.
The rule posted on the CMS website http://cms.hhs.gov/physicians/pfs/ will increase payments on average by about 1.5% to physicians and other healthcare professionals for services under Medicare, according to CMS.
These increases were part of the Medicare Prescription Drug, Improvement, and Modernization Act (DIMA) and replace payment rates published in November that would have reduced payment rates by an average of about 4.5 percent. The earlier rates were based on formula required by Medicare law, but President Bush signed the DIMA law on December 8 that included provisions to raise physician payment rates. The new, higher rates become effective January 1.
Because of the late timing of the change in payment rates under this rule, CMS is extending until February 17 the deadline for physicians to decide whether or not they want to participate in Medicare in 2004.
The new rule will establish more accurate Medicare payment for drugs and their administration. The rule reduces payment for injectible and certain other drugs covered by Medicare to more closely reflect the prices actually charged to physicians by their suppliers. Under the new rule, Medicare will pay for most of these drugs at the lesser of the actual charge or 85 percent of the April 1, 2003 AWP. In addition, Medicare will increase payment for the administration of drugs.