Oncologists will get an average 6%
increase from Medicare in calendar 2001. That puts them about midway amongst
specialists, with optometrists getting a 12% hike and gastroenterologists coming
out with a big goose egg.
All specialties start out with a 5.1% increase, owing
to an increase in the conversion factor to $38.2581 The conversion factor is the
dollar figure against which the total relative value units (RVUs) for a
particular CPT code is multiplied. However, in 2001 the 5.1% increase each
specialty gets will be further modifiedup or downbased on changes to the
RVUs for the particular CPT codes they bill. The three key elements of those
RVUs are physician work, practice expense, and malpractice expense. Practice
expense is the key area of change.
Under the direction of Congress, Medicare has
been on a 4-year schedule to shift practice expenses from historical to
resource-based, and 2001 is the third year of the transition period. Practice
expenses will be 25% historical to 75% resource-based. The continuing shift in
2001 is scheduled to reduce oncologists’ share of the practice expense pie by
2% below what it might otherwise have been. Keep in mind, however, that
reimbursement for oncology-heavy CPT codes is increasing just a little less than
it would have without the 2001 practice expense changes.
Medicare also made some
changes to individual CPT codes that have nothing to do with the 4-year shift.
Oncologists got a big victory when Medicare decided to reinstate the 10 minutes
of clinical staff time to the practice expense RVUs for two chemotherapy
administration CPT codes96408 (intravenous, push technique) and 96410
(intravenous, infusion technique, up to 1 hour).