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CMS-1403-FC payment impacts reflect averages for each specialty based on Medicare utilization. The payment impact for an individual physician would be different from the average, based on the mix of services the physician provides. The average change in total revenues would be less than the impact displayed here because physicians furnish services to both Medicare and non-Medicare patients and specialties may receive substantial Medicare revenues for services that are not paid under the PFS. For instance, independent laboratories receive approximately 80 percent of their Medicare revenues from clinical laboratory services that are not paid under the PFS. Table 47 shows only the payment impact on PFS services. The following is an explanation of the information represented in Table 47. ● Specialty: The physician specialty or type of practitioner/supplier. ● Allowed charges: Allowed charges are the Medicare Fee Schedule amounts for covered services and include coinsurance and deductibles (which are the financial responsibility of the beneficiary.) These amounts have been summed across all services furnished by physicians, practitioners, or suppliers within a specialty to arrive at the total allowed charges for the specialty. 1040
CMS-1403-FC ● Impact of Work RVU Changes for any new or revised CY 2009 PFS services. ● Impact of PE RVU changes. The impact is shown for both 2009 which is the third year of the 4-year transition using the new methodology and the fully implemented 2010 PE RVUs. ● Combined impact of the work RVUs and PE RVUs for both 2009 and the fully implemented 2010 PE RVUs. TABLE 47: Combined Total Allowed Charge Impact for Work and Practice Expense RVU Changes Impact of Work RVU Impact of PE RVU Combined Impact of PE Changes Changes and Work Changes* 2009 2009 (PE 2010 (PE 2010 Allowed Trans. (PE Full Trans. (PE Full Specialty Charges (mil) 2009 Year 3) Implement.) Year 3) Implement.) 1 TOTAL $ 81,669 0% 0% 0% 0% 0% 2 ALLERGY/IMMUNOLOGY $ 184 0% 1% 2% 1% 2% 3 ANESTHESIOLOGY $ 1,966 0% -1% -1% -1% -1% 4 CARDIAC SURGERY $ 400 0% 0% 0% 0% 0% 5 CARDIOLOGY $ 7,775 0% -2% -3% -2% -4% 6 COLON AND RECTAL SURGERY $ 136 0% 1% 1% 0% 1% 7 CRITICAL CARE $ 224 0% 0% 0% 0% 0% 8 DERMATOLOGY $ 2,557 0% 2% 5% 2% 5% 9 EMERGENCY MEDICINE $ 2,451 0% 0% 0% 0% 0% 10 ENDOCRINOLOGY $ 385 0% 0% 0% 0% 0% 11 FAMILY PRACTICE $ 5,354 0% 0% 1% 0% 1% 12 GASTROENTEROLOGY $ 1,883 0% 2% 3% 2% 3% 13 GENERAL PRACTICE $ 842 0% 0% 0% 0% 0% 14 GENERAL SURGERY $ 2,408 0% 0% 1% 1% 1% 15 GERIATRICS $ 175 0% 0% 1% 0% 1% 16 HAND SURGERY $ 88 0% -1% -2% -1% -2% 17 HEMATOLOGY/ONCOLOGY $ 2,019 0% -1% -1% -1% -1% 18 INFECTIOUS DISEASE $ 561 0% 1% 2% 1% 2% 19 INTERNAL MEDICINE $ 10,662 0% 0% 0% 0% 0% 20 INTERVENTIONAL RADIOLOGY $ 228 0% -1% -1% -1% -2% 21 NEPHROLOGY $ 1,840 0% -1% -2% -1% -2% 22 NEUROLOGY $ 1,489 0% 0% 0% 0% 0% 23 NEUROSURGERY $ 620 -1% 0% -1% -1% -2% 1041
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<strong>CMS</strong>-1403-FC<br />
● Impact of Work RVU Changes for any new or revised<br />
CY 2009 PFS services.<br />
● Impact of PE RVU changes. The impact is shown for<br />
both 2009 which is the third year of the 4-year transition<br />
using the new methodology and the fully implemented 2010 PE<br />
RVUs.<br />
● Combined impact of the work RVUs and PE RVUs for<br />
both 2009 and the fully implemented 2010 PE RVUs.<br />
TABLE 47: Combined Total Allowed Charge Impact for<br />
Work and Practice Expense RVU Changes<br />
Impact of<br />
Work RVU Impact of PE RVU Combined Impact of PE<br />
Changes<br />
Changes<br />
and Work Changes*<br />
2009<br />
2009<br />
(PE 2010 (PE 2010<br />
Allowed<br />
Trans. (PE Full Trans. (PE Full<br />
Specialty<br />
Charges (mil) 2009 Year 3) Implement.) Year 3) Implement.)<br />
1 TOTAL $ 81,669 0% 0% 0% 0% 0%<br />
2 ALLERGY/IMMUNOLOGY $ 184 0% 1% 2% 1% 2%<br />
3 ANESTHESIOLOGY $ 1,966 0% -1% -1% -1% -1%<br />
4 CARDIAC SURGERY $ 400 0% 0% 0% 0% 0%<br />
5 CARDIOLOGY $ 7,775 0% -2% -3% -2% -4%<br />
6 COLON AND RECTAL SURGERY $ 136 0% 1% 1% 0% 1%<br />
7 CRITICAL CARE $ 224 0% 0% 0% 0% 0%<br />
8 DERMATOLOGY $ 2,557 0% 2% 5% 2% 5%<br />
9 EMERGENCY MEDICINE $ 2,451 0% 0% 0% 0% 0%<br />
10 ENDOCRINOLOGY $ 385 0% 0% 0% 0% 0%<br />
11 FAMILY PRACTICE $ 5,354 0% 0% 1% 0% 1%<br />
12 GASTROENTEROLOGY $ 1,883 0% 2% 3% 2% 3%<br />
13 GENERAL PRACTICE $ 842 0% 0% 0% 0% 0%<br />
14 GENERAL SURGERY $ 2,408 0% 0% 1% 1% 1%<br />
15 GERIATRICS $ 175 0% 0% 1% 0% 1%<br />
16 HAND SURGERY $ 88 0% -1% -2% -1% -2%<br />
17 HEMATOLOGY/ONCOLOGY $ 2,019 0% -1% -1% -1% -1%<br />
18 INFECTIOUS DISEASE $ 561 0% 1% 2% 1% 2%<br />
19 INTERNAL MEDICINE $ 10,662 0% 0% 0% 0% 0%<br />
20 INTERVENTIONAL RADIOLOGY $ 228 0% -1% -1% -1% -2%<br />
21 NEPHROLOGY $ 1,840 0% -1% -2% -1% -2%<br />
22 NEUROLOGY $ 1,489 0% 0% 0% 0% 0%<br />
23 NEUROSURGERY $ 620 -1% 0% -1% -1% -2%<br />
1041
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