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Physician fee schedule rules

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The Centers for Medicare & Medicaid Services (CMS) reimburses physicians for care furnished to Medicare Part B beneficiaries based on the Medicare Physician Fee Schedule (PFS), which lists the payment rates for more than 12,600 unique covered services. The PFS contains the resource costs associated with the physician work, practice expense and malpractice insurance for the current procedural terminology (CPT), and Healthcare Common procedure Coding System (HCPCS) codes that represent office visits, surgical procedures, anesthesia services, diagnostic tests, and a range of other therapies. The rule also addresses Medicare billing requirements, quality standards, program integrity, and other issues impacting physician practices. CMS updates the PFS annually and publishes a proposed rule to allow for public comment before finalizing its policies.