July 1, 2009

MEDICARE PHYSICIAN PAYMENTS: Fees Could Better Reflect Efficiencies Achieved When Services Are Provided Together

This report examines (1) CMS's current efforts to ensure that Medicare physician fees reflect efficiencies in services commonly furnished together and (2) additional opportunities for CMS to avoid excessive payments for Medicare physician services commonly furnished together. To determine how CMS ensures that Medicare physician fees reflect efficiencies for services commonly furnished together, CMS's relevant payment policies and applicable laws and regulations were reviewed. Officials were interviewed from several organizations to discuss other instances where the physician fee schedule could better reflect efficiencies for these services. These organizations included CMS, the Medicare Payment Advisory Commission (MedPAC), and 7 of the 15 Medicare contractors.