The Centers for Medicare & Medicaid Services (CMS) has issued a corrected 2010 Medicare Physician Fee Schedule (MPFS), available on its Web site.

Updated PFS relative value units (RVUs) include technical corrections for CPT® codes G0341, 29870, 36481, 37183, 47382, 50200, 55873, 92610, 99221, 99222, 99223, 99304, 99305, and 99306.

The 2010 conversion factor contained in the 2010 MPFS final rule has also been modified. The 2010 conversion factor is now $28.3895, instead of $28.4061 as previously indicated in the final rule.

CMS indicated that a correction notice will be published in the Federal Register regarding these corrections, but did not specify when.

25 Responses to “2010 Medicare Physician Fee Schedule Update”

1. Denise D Miller CPC Says:
   December 2nd, 2009 at 10:41 am

   When are we getting the new modifier for H&P`s?

2. Cindy McGarry CPC-P Says:
   December 2nd, 2009 at 10:49 am

   At an audio conference yesterday, we were told that the new modifier for the admitting physician will be AI (the letter I, not number 1).

3. Rebecca Lopez Says:
   December 2nd, 2009 at 11:33 am

   A live webninar from MGMA dated 11.18.09 and the presentors were Nancy Enos,Joan Gilhooly. They have on the handout that the Modifier A1 ( one).

   ” The admitting/attending physician of record will be requried to append the specific modifer to the initial hospital care or initial nursing facility care code which will identify him or her as the admitting physician of record who is orverseeing the patient’s care, Preliminary indication are the modifier will be A1″

   Hopefully some one can clarify!

4. Susan Hedges Says:
   December 2nd, 2009 at 12:22 pm

   Say it isn’t so Rebecca! That is just going to be a nightmare if the modifier is required by the “admitting physician”. We might as well just stop doing inpatient consults altogether!

   I am so annoyed that the Gov’t has to constantly make it more difficult for the honest physicians to make a living instead of figuring out ways to only get rid of the ‘bad guys’.

   DECREASING income, eliminating consults (which also decreases income), all while REQUIRING docs to conform to E-Scripting, EHR, ICD-10 in the future……..really? who in their right mind would aspire to be a Doctor these days? How sad that our country is going this way. Can’t wait until I’m 65
   Thanks for letting me vent. :-)

5. Louise Rodriguez Says:
   December 2nd, 2009 at 12:38 pm

   This may be a dumb question, but I went to CMS website, and even my trailblazer health (regional medicare) website and cannot find where the fee schedule is…any suggestions? would be appreciated…thanks Louise

6. Mary Ellen Fletcher Says:
   December 2nd, 2009 at 2:21 pm

   Hi Louise,

   The final rule may be found at:

   http://edocket.access.gpo.gov/2009/pdf/E9-26502.pdf and the fee schedule begins on page 281 of the document. CPT codes begin on page 283. Hope this helps.

7. Holly McDaniel Says:
   December 2nd, 2009 at 3:24 pm

   Does anyone know if there will be new codes for hospital consults cpt codes 99254 & 99245. They are deleted in MCR fee schedule.
   Thanks

8. Peggy Smith CPC Says:
   December 2nd, 2009 at 3:34 pm

   Hi all
   Per the CMS website:

   AI Principal Phy of Record
   AF Specialty Phy
   AG Primary Phy

   A1 Dressing for 1 wound
   http:/www.cms.hhs.gov/apps/ama/license.asp?file=/HCPCSReleaseCodeSets/Downloads

   Hope this helps

   Peg

9. Nancy Enos, FACMPE CPC-I CEMC Says:
   December 3rd, 2009 at 7:55 am

   Rebecca, The modifier has not been officially announced by CMS. You are correct, the 2010 HCPCS modifier list includes AI as “PRINCIPAL PHYSICIAN OF RECORD”.

   A Carrier Director mentioned A1 as a possible modifier at the AMA’s CPT symposium. It was not official, and it was mentioned in the MGMA webinar as “unofficial” pending CMS clarification.

10. shana Says:
    December 3rd, 2009 at 8:04 am

    Peggy,
    where did you find your information on the different modifiers?

11. Tom Stickel, CPC Says:
    December 3rd, 2009 at 9:08 am

    I’m seeing about 20% reduction from 2009. Does anybody concur? I guess it’s a bad time to quit my Lexapro.

12. Peggy Smith CPC Says:
    December 3rd, 2009 at 10:02 am

    Shana
    On the CMS website. I put it on my post under the A1 modifier.

13. Peggy A Says:
    December 3rd, 2009 at 2:11 pm

    Peggy
    I tried following the link the CMS web-site for the modifiers AI,Af and AG, but it didn’t take me to the right place. Can you forward to me again, please?
    Thanks

14. Louise Rodriguez Says:
    December 4th, 2009 at 8:23 am

    Thank you Mary Ellen I appreciate your help!

15. Liz G Says:
    December 7th, 2009 at 11:37 am

    How do we find the link that give the description of modifier AI, AF AG?

16. Barbara F Says:
    December 14th, 2009 at 7:20 am

    The link for the new Medicare HCPCS is long but here goes:

    http://www.cms.hhs.gov/HCPCSReleaseCodeSets/ANHCPCS/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=descending&itemID=CMS1230217&intNumPerPage=10

    Look for the “10anweb.xls” (win zip file)

    You may otherwise search for: 2010 Alpha-Numeric HCPCS File in the CMS website.

17. Jennifer Yarnall, CPC Says:
    December 15th, 2009 at 10:39 am

    Hi everyone,

    As Tom Stickel mentioned in the above comment, Medicares new fee schedule for 2010 did decrease by 18% to 19%. I was doing research for my doctors on the elimination of consultation codes when I stumbled across this disturbing revelation. My practice consists of pulmonoligists and my doctors are going to loose it when they find out that not only is Medicare eliminating consultations, but now they’re decreasing payment for E&M codes as well? Talk about adding insult to injury! I hope they don’t shoot the messenger. According to the article I read in CHESTS’ website, Medicare was suppose to offset the elimination of the consult codes by increasing payment for outpatient/office codes by 6% and initial hospital visit codes by 2%. Can anyone tell me what is going on? This is a nightmare!

18. Julie Larson Says:
    December 16th, 2009 at 3:57 pm

    To Tom and Jennifer,
    I too have noticed the 20% decrease, and have yet to find anything anywhere in regard to this. I was looking for the “2% to 6% increase” but it seems to be evading me also! I’m meeting with my docs tonight and they are aware of it, but I am still taking my Lexapro!!

19. Susan Hedges Says:
    December 17th, 2009 at 8:53 am

    Unfortunately it is only after I did an analysis of the projected loss of income that I realized that Medicare IS increasing the reimbursement for E/M codes but ONLY AFTER decreasing the entire fee schedule by 21.2%! That’s like saying ‘you’re getting a 6% raise (YAY!) BUT we have to cut your salary by 15% (YIKES!)
    Not sure why the gov’t thinks it is feasible to promote pay cuts to everyone but themselves. If Congress doesn’t stop this fee schedule cut from happening (and stop the yearly time wasting of going through this situation time after time) I’m pretty sure we’re going to have to start going out of the country just to FIND a Dr. Who wants to waste half their life in Medical school paying astronomical tuition only to be paid less than the school janitor?
    Well, at least Medicare finally published the process for billing Inpatient codes as admits.
    Good luck everyone!

20. Jamie Says:
    January 14th, 2010 at 1:42 pm

    OK CAN ANYONE HELP ME WHO IS CONSIDERED THE PRINCIPAL PHYSICIAN OF RECORD????

21. Jamie Claypool CPC Says:
    February 2nd, 2010 at 6:22 pm

    If and when these modifiers are confirmed by the CMS are they to be used only on hospital services?What about in the office?

22. stephanie Says:
    February 4th, 2010 at 7:39 pm

    My billing company is telling me that AI is invalid not in their system. Should I tell them to update their system or do we have to use the AI code when billing? I’m so confused now!

23. Annette Says:
    June 2nd, 2011 at 9:37 am

    Modifier AL would be used for Principal Physician of Record

24. TAMARA TAYLOR Says:
    August 17th, 2011 at 1:00 pm

    SO IS THE AI MODIFIER ONLY FOR MEDICARE PATIENTS AND IS THE CODE VALID NOW? DO WE ONLY USE IT ON THE ADMIT DATE OR DO WE ALSO USE IT FOR THE ROUNDS IN THE HOSPITAL?

25. RN web » nevada medicare physician fee schedule 2010 Says:
    February 13th, 2012 at 5:21 am

    [...] 14.2010 Medicare Physician Fee Schedule Update | AAPC News Nov 30, 2009… (12-18 CEUs). Las Vegas, NV National (April 1-4, 2012) …. 24 Responses to “ 2010 Medicare Physician Fee Schedule Update”. Denise D … http://news.aapc.com/index.php/2009/11/2010-medicare-physician-fee-schedule-update/ [...]

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