Medicare Carrier Advisory Committee (CAC) Updates - Follow-Up

Following our release of the fee schedule increase for Medicare codes 98940,-41 and -42 there seemed to be some disappointment in the overall results. While we all acknowledge that the most commonly used code, 98940 (thanks to Medicare audits), had the lowest percentage increase, the implicates can have far reaching impact as other carriers look to the RVU that Medicare sets. In addition, the ACA Medicare Carrier Advisory Committee and executives of the ACA have been diligently meeting the CMS and HHS to get us full scope coverage to include E & M codes as well as active and passive modalities. Unfortunately, as we know just from our dealings in NY that major changes take time. In the interim, a 2% increase in 98940 is better than another decrease, and as we draw closer to paying off the 2% reduction due to the overage of the demonstration project (thanks to some of our colleagues in part of Chicago), that decrease is anticipated to be lowered in the coming year.

For further information on the efforts of the ACA, please check out the following links:

• ACA Responds to Joint Congressional Discussion Draft on Medicare Physician Payment Reform (Nov 2013) 
• ACA RUC Advisors Comment to CMS on DCs Billing for Evaluation & Management (E/M) Services 
• ACAtoday.org Medicare Advocacy 

Respectfully submitted,
Mariangela Penna, DC
NY CAC Representative