HIDA Government Affairs Alert

July 17, 2014

HIDA Releases Summary of the CY 2015 Physician and Lab Proposed Rules

The HIDA Government Affairs team has reviewed the CY 2015 Physician and Lab proposed rules and written a summary of the important policy takeaways.

In the summary, HIDA explains that the Centers for Medicare & Medicaid Services (CMS) is proposing that physicians receive a 0% update in payment rates from January 1, 2015 to March 31, 2015 and a 20.9% decrease in reimbursement for the rest of 2015. However, Congress is expected to implement a new “doc fix” bill and avert the reduction before the decrease takes place.  CMS expects that labs will receive an overall 3% increase in reimbursement payment rates for CY 2015.  Other key highlights from the proposed rules include:

  • Increase in payments to primary care and decrease in radiation therapy centers and radiation oncology payments
  • New $41.92 payment rate for a one per month per patient Chronic Care Management (CCM) code
  • Adds 28 new individual measures and two new measure groups, totaling 240 overall measures
  • Eligible professionals (EPs) must now report nine measures from at least three of the national quality domains through PQRS
  • Adds four services to telehealth services for reimbursement
  • Delay of CLFS price rebasing until 2017
  • Extend the rebasing period to six years instead of five.

CMS is expected to finalize these rules later this fall.

Please contact HIDA Government Affairs if you have any questions, hidagovaffairs@hida.org or (703) 549-4432.