CMS to Hold Claims for 10 Business Days & Extends Participation Deadline

This past week Congress acted to avert the 21.2% Medicare physician payment cut and on December 19, the President signed into law the Department of Defense Appropriations Bill (H.R. 3326) which will stop the cuts until March 1, 2010.  Other changes reflected in the 2010 Medicare Physician Fee Schedule final rule will still take effect on January 1, 2010 and may have a slight impact on the conversion factor used for the first two months of 2010.  Similar to other years, since Congress acted so late in the year to avert the cut, the Center for Medicare and Medicaid Services CMS will hold claims for the first 10 business days of January (January 1 through January 15) for 2010 dates of service to allow its contractors time to update their systems and pay claims based on the updated rates CMS does not anticipate any cash flow problems for physicians since by law no claims are paid prior to 14 days after receipt anyway. 

In addition, CMS has extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010. Physicians still have time to consider their participation options with the Medicare program.

The effective date for any participation status change during this extension remains January 1, 2010, and will be in force for the entire year.  Medicare contractors will accept and process any participation elections or withdrawals made during the extended enrollment period that are received or post-marked on or before March 17, 2010.

We continue to work for a permanent correction to the Medicare payment formula.

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