AAPM&R is aware of the drastic NCS and EMC reimbursement cuts that are currently impacting physiatrists. As more information becomes available, we will continue to update this Web page and share information through the various Academy communication vehicles (i.e., Connection, The Physiatrist, Member Council Info Letters, etc.).
The Latest Update
The Academy will participate in meetings with the Director of the Center for Medicare, Jonathan Blum, in the next few months. The Academy believes that these additional meetings commissioned by CMS in early in 2013 are a positive step as we continue to work with CMS and set the possibility of reevaluating the codes for 2014. CMS has outlined their intent of setting forth some resources designated to monitoring claims data to demonstrate the impact that the American Academy of Physical Medicine and Rehabilitation (AAPM&R), the American Academy of Neurology (AAN) the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) and the American Physical Therapy Association (APTA) described in the December 20, 2012, meeting with CMS. All stakeholders (AAPM&R, AAN, AANEM, and the APTA) will have an ongoing role in this project. The details and scope of this project will be worked out in early 2013, in which time there will be another, more detailed report.
What Happened and What Your Academy Is Doing to Advocate for You
On November 1, 2012, CMS published the Final Rule for the "Revisions to Payment Policies under the Physician Fee Schedule, DME Face-to-Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013."
AAPM&R analyzed the changes related to RVUs for EMGs and NCS and worked jointly with AAN and AANEM to determine next steps in addressing these issues directly with CMS and the potential impact these changes may have on the specialty of physiatry.
The Academy addressed several concerns related to the Final Rule by:
Projected Cuts to Nerve Conduction Studies and EMGs for 2013- Drafting a Dear Colleague letter to be circulated in Congress. The letter was endorsed and sponsored by Reps. Roskam (R-IL) and Ruppersberger (D-MD) and as of December 13, 2012, was signed by 11 other members of Congress. The letter will be sent to CMS prior to the meeting scheduled for December 20.
- Distributing a coalition letter to members of Congress signed by nearly 75 patient, provider, physician, and academic groups urging them to support this effort.
- Sending out an Academy-wide action alert, which garnered record participation, to urge members to write their representatives to ensure their support on the Dear Colleague letter.
- Receiving confirmation of a face-to-face meeting request with CMS Director Jonathan Blum. The meeting was scheduled for Thursday, December 20, 2012, at CMS headquarters.
December 20, 2012, CMS Meeting Details
On December 20, 2012, the Academy participated in a meeting at CMS with the Director of the Center for Medicare, Jonathan Blum. The meeting was initiated to discuss the recent NCS/EMG cuts which were released as part of the SGR Final Rule. Dr. Barry Smith and Dr. Andrea Boon represented the Academy. The goal was to express the impact of the cuts on patients and physician practices and ask CMS for a phase-in period for the cuts to go into effect over 4 year period, during which time stakeholders such as the AAPM&R, AAN, AANEM and the APTA would work with CMS and the American Medical Association’s Specialty Society Relative Value Scale Update Committee (RUC) to develop an integral plan to combat fraud and abuse and to drive down costs of over utilization.
Jonathan Blum explained that at this time the possibility of a phase-in was not a viable option due to Practice Expense (PE) components across multiple specialties. As a result, the items outlined in CMS’ Final Rule went into effect on January 1st, 2013. However, Mr. Blum has committed CMS to meeting with the group again in early 2013 to evaluate the impact of the cuts on patients and the different provider specialties these cuts will be impacting based on claims data information.