HCFA Announces Year 2001 Medicare Fee Schedule

An increase of 4.5% in the Medicare conversion factor (which translates the Relative Value Units (RVUs) for Medicare into actual payments) will partially offset the continued reductions in practice expense RVUs in next year’s Medicare Fee Schedule. Effective January 1, 2001, the conversion factor will be $38.2581.

Using this conversion factor, reductions in reimbursement for cardiac surgical fees in 2001 will be in the range of 1.4% (aortic valve replacement) to 2.8% (three-vessel CABG using one arterial graft). Reimbursement for most general thoracic procedures will be essentially unchanged.

HCFA has again rejected STS’ position that practice expense reimbursement for thoracic surgery should include the costs incurred by surgeons for staff who assist them in the hospital. The agency has now accepted the validity of our information showing that these costs are often incurred, but still maintains that the law providing that hospitals be compensated for medical services requires them to provide this care. HCFA has agreed “that it would be helpful to determine whether hospitals are still providing the staffing that is assumed in their DRG payments” and has asked the office of the Inspector General of the Department of Health and Human Services “to conduct an independent assessment of staffing arrangements between hospitals and thoracic surgeons”

Following are current and future average national fee schedules for selected thoracic procedures. Individual locality fee schedules vary according to the local geographic practice cost adjustments.