Medicare :: ACP commends proposed changes to payments for physician work at nursing facilities

The American College of Physicians commended the Centers for Medicare and Medicaid Services on its recent decision to increase the work relative value units for codes used in the nursing home setting.

?These increases in value are a testament to the extraordinary level of work required of physicians that work in nursing facilities,? said David C. Dale, MD, FACP, president of ACP said. ?This increase in value should help to make work in the nursing home as attractive as work in other settings.?

?ACP was pleased to work with the American Medical Directors Association (AMDA) in assisting in the presentation of these codes to the Relative Value Update Committee (RUC),? Dr. Dale continued. ?The RUC recommended significant increases in the value of these services and CMS accepted those recommendations. AMDA did a commendable job in presenting this information and we were grateful to work with them on this issue.?

?Internists and internal medicine subspecialists provide a great amount of care in the nursing facility setting,? added Dr. Dale. ?Because patients are moved from more intense settings much more quickly than in the past, patients in nursing facilities are often in very serious condition as they are cared for by their physician. These work values are a reflection of this extraordinary responsibility.?

ACP has recommended that CMS include the proposed increases in nursing home work values when it publishes its final fee schedule rule on Nov. 1.

The increase in work values for nursing home codes follows last year?s decision by CMS to increase the work values for many codes for office, hospital, and emergency room visits. Work values for initial nursing home visits increased by more than 40 percent, work values for subsequent nursing home visits increased by between 9 percent and 26 percent and the work value for the annual nursing home visit increased by more than 32 percent. Approximately 55 percent of the payment for a service is determined by the level of the work RVU.

New Current Procedural Terminology (CPT) codes were created for nursing home services in 2006, but work values were tied to the old codes that described different services. The work valuation for the nursing home codes is the first time that work value has been assigned to these codes based on a survey of physicians that perform the service.

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