CMS Releases Medicare Physician Fee Schedule's Final Rule
CMS has released the final rule on the 2004 Medicare physician fee schedule and did not decrease the practice expense portion of this service as threatened in the proposed rule.

The relative values for administering vaccines remain the same as in 2003.

The new average for 2004 will be $7.38 as compared to $7.72 for 2003.

The 4.5% decrease is due to a decrease in the conversion factor, which affects all physician services and can only be changed by Congress. Last year the conversion factor was supposed to decrease by 5.4% and Congress did step in to stop the decrease and actually implemented a 1.9% increase over the 2002
figure. A similar remedy may happen again this year and reports are that the prescription drug benefit when passed by Congress blocks the 4.5% decrease with a 1.5% increase.

An average of $7.38 is great news because CMS had proposed in August to decrease this payment to an average of $4.93.

At press time we are still waiting to hear what CMS will do with product reimbursement next year (hopefully exclude vaccines from any negative changes). CMS is delaying publication of that change giving Congress a chance to make any change to AWP reimbursement in the prescription drug benefit legislation.