26.5 percent Medicare payment cut averted for 2013

Jan. 17, 2013—As the APA Practice Organization reported in an email to members early this month, Congress enacted the “American Taxpayer Relief Act” (HR 8) on Jan. 2, 2013. The law blocks the drastic 26.5 percent Sustainable Growth Rate (SGR) cut through 2013.

The new law also delays for two months the automatic spending cuts referred to as sequestration for military and domestic programs, including an across-the-board cut to all Medicare provider payments of up to two percent. Barring further congressional action, the automatic spending reductions will take effect in early March.

2013 Medicare Administrative Contractor (MAC) fee schedules published before the new law took effect included the SGR cut, and thus reflected significantly lower fees than the current Medicare fee schedule.

The following MACs posted updated fee schedules online this week: 

We expect that the remaining MACs will release their revised fee schedules soon.

Without the combined advocacy of patients, APAPO and our allies in the provider community, and the more than 40,400 messages sent directly by psychologists to their elected officials, the SGR fix would not have made it into the American Taxpayer Relief Act. APAPO thanks members for their grassroots efforts that contributed to this outcome.

Passage of HR8 marks the 15th time Congress has blocked the SGR cut since 2001. The APA Practice Organization (APAPO) will continue in 2013 to advocate for permanently replacing the flawed SGR formula with a payment system that appropriately values the cost-efficient services that psychologists provide.

Final Medicare Fee Schedule Results in Payment Reductions

As previously reported in our PracticeUpdate e-newsletter, psychologists who participate in Medicare are already experiencing a  two percent average reduction in 2013 payments  for psychological services effective Jan. 1 as a result of the final 2013 Medicare fee schedule announced by the Centers for Medicare and Medicaid Services last November. The average projected reduction pertains to all billing codes used by psychologists, including health and behavior and testing codes.