The Academy is moving on several fronts to address the surprising final rule issued on November 1, 2012, by the Centers for Medicare & Medicaid Services (CMS) on the 2013 Medicare Physician Fee Schedule (MPFS) that severely reduces reimbursement for EMG and nerve conduction test codes.
CMS never posts decisions regarding new codes as part of the proposed rule, which was released last August. However, CMS typically accepts valuations approved through the AMA RUC process, in which the AAN actively participates. There was no way for the Academy to know before the final rule was published that CMS would make such drastic reductions.
Physicians who provide nerve conduction and needle EMG services will face dramatic cuts of more than 50 percent for some services starting January 1, 2013. According to CMS, the reduction is a result of the "potentially misvalued code" initiative.
The AAN leadership and staff recognize the impact the CMS reductions will have on AAN members and their patients. "I'm deeply disappointed that CMS has found it acceptable to cut reimbursement to neurologists so drastically," said AAN President Bruce Sigsbee, MD, FAAN. "The proper valuation of EMG and nerve conduction codes is critical to ensuring the sustainability and accessibility of these services to our patients. The Academy will pursue every recourse available to appeal this decision. However, practices need to prepare and adapt to the new reality of payment cuts."
Although the ruling goes into effect in January 2013, the AAN is looking at every possible avenue to alter the values in the next year. The Academy is working with the American Association of Neuromuscular & Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation to propose higher values for these services or a phase in of the cuts, and will continue to work with those societies to advocate for better reimbursement whether it be at CMS or in the halls of Congress.
The AAN is aware that this is a drastic cut that will be especially hard on neurology practices large and small, many of which rely on these services to meet their bottom line. Patients also will pay the price with less access to these services. Private health insurers often follow Medicare payment rules as well, which will exacerbate the situation.
The AAN is committed to advocating for you and preparing you for these changes. For more information, visit www.aan.com/go/practice/coding.
The AAN will host a FREE webinar, "Master 2013 CPT Coding Changes for Nerve Conduction Studies and EMG," on Tuesday, December 4, 2012, from 12:00 p.m. to 1:30 p.m. ET to discuss the new nerve conduction codes and EMG. The webinar is free to AAN members and $99 for nonmembers. A recording of this webinar will be available within five business days of the live event.