NYSPA 2016 MEDICARE FEE SCHEDULES 

NYSPA 2015 MEDICARE FEE SCHEDULES

Following are both the fee schedules for January through June 2015 and the revised fee schedules for July through December 2015. Please note that there are separate schedules for Facility and Non-Facility fees and that each schedule includes Participating Fees, Non-Participating Fees and NYS Limiting Charges.

Under each of the Primary headings (Participating, Non-Participating and NYS Limiting Charge), you will find six sub-headings. Providers will need to choose the appropriate sub-heading as follows: 

2015 Medicare Fees

On January 21, 2015, the Centers for Medicare and Medicaid Services (CMS) announced that it was making emergency changes to the 2015 physician fee schedule because of calculation errors made by CMS. Because of these CMS errors, fees downloaded from the NYSPA website are incorrect. The fee schedules are currently being updated and the revised fee schedules will be posted here as soon as they are complete. Click here to access the CMS newsletter, MLN Matters, announcing emergency changes.

In addition, the original fee schedules published by the Medicare carrier, National Government Services (NGS) failed to properly calculate the EHR penalty.

Providers who did not meet the EHR meaningful use requirements in 2013 but were successful electronic prescribers or applied for and received an electronic prescribing waiver in 2013 are subject to only a 1% EHR cut in their 2015 fees.

However, providers who have not met meaningful use requirements in 2013 and were also not successful electronic prescribers or did not secure an eRx waiver in 2013 are subject to a 2% EHR cut in their 2015 fees. Thus, the EHR cut is either 1% or 2%. Our corrected NYSPA fee schedules will incorporate the newly corrected fees from CMS and the correct calculation of the EHR reduction. We will send out an E-Bulletin notifying members when the revised fees have been uploaded to the NYSPA website.

2015 Medicare/PQRS Update Webinar

Presenter: Seth P. Stein, Esq. & Rachel A. Fernbach, Esq.
Webinar Date: December 15, 2014