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Medicare proposes payment rule for preventive benefits, raises physician payments

Physician Practice Advisor, July 30, 2004

CMS announced July 27 new benefits to help Medicare beneficiaries stay healthier and receive better access to preventive medical services. The agency is also planning a 1.5% increase in payment rates for physicians who care for Medicare beneficiaries.

The new payments are part of CMS' physician fee schedule rule for 2005. Key areas of the initiative include the following:

  • A "welcome to Medicare physical," a preventive examination for all new Medicare beneficiaries
  • New coverage for cardiovascular screening blood tests for the detection of cardiovascular disease or related abnormalities and coverage for diabetes screening tests for those at risk
  • Total Medicare spending for more than 875,000 physicians and other healthcare professionals will increase by more than 4% from a projected $52.7 billion in 2004 to a projected $55 billion in 2005
  • New incentive payments of 5% made to primary care and specialty physicians providing services in areas with the lowest 20% of physician-to-beneficiary ratios
  • New telehealth billing for most monthly management services for dialysis patients.

    To read CMS' fact sheet, click here.

    To read the press release, click here.

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