New Fee Schedule for 2006
The fees for 2006 Medicare services have changed. Instead of a 4.4% average decrease from 2005 reimbursement rates, Congress has enacted an average 0% decrease for 2006 services. Providers do not need to make any change to receive the accurate reimbursement for claims with 2006 dates of service (DOS).
Your 2006 reimbursement rate may be different from 2005 fee schedule rates
The CMS announced a 0% average decrease for reimbursement of services - this is only an average. Some fees are being reimbursed at a higher rate than in 2005, some at a lower rate, and some have stayed the same as 2005 rates. CMS adjusted Geographical Price Cost Indexes (GPCIs) and Relative Value Units (RVUs) on some procedure codes, resulting in changes from 2005 to 2006 reimbursement rates. (You would need to compare the fees released on February 9, 2006 with the rates you used on your billing for 2005 dates of service to calculate any potential differences.) We recommend that you begin billing with the new fees immediately. WPS Medicare will reprocess and do mass adjustments on claims already processed for January 1, 2006 dates of service so that you receive accurate reimbursement under the newly revised 2006 fee schedule.
2006 CLAIMS SUBMITTED PRIOR TO FEBRUARY 2, 2006
WPS Medicare will re-process claims with dates of service January 1, 2006 and after, received prior to February 2, 2006, as mass adjustments. Providers do not need to take any action to receive the updated reimbursement for those claims. WPS Medicare will adjust these claims in cycles over time, with all cycles reaching completion by July 2006. Providers may continue to see adjustments on their remits through June 2006 for claims (with DOS January 1 and after) submitted prior to February 2, 2006.
2006 CLAIMS SUBMITTED FEBRUARY 2, 2006 - CURRENT
Claims that WPS Medicare received February 2 to date with dates of service January 1, 2006 and after were held by carriers by order of the Centers for Medicare & Medicaid Services (CMS) and will process under the new fee schedule starting February 13. WPS Medicare will process claims submitted after February 2 with dates of service January 1, 2006 and after under the new fee schedule. Providers do not need to take any action to receive the 0% average decrease reimbursement for affected services.
NEW FEES AVAILABLE ON WEBSITE
Please note that this change is an AVERAGE 0% decrease, so the adjustment will not necessarily be equal for every procedure code, just as the previous 4.4% average decrease did not affect all procedure codes equally. We posted the new fee schedules for our jurisdiction here. Please review the specific adjustments for services you provide, and adjust your billing on all future claims you submit for Medicare Part B services.
Page Last Updated: Tuesday, 04-Dec-2007 13:19:04 CST
