Medicare reimbursement amounts ultimately paid to individual practitioners will differ due to geographic adjustments applied to national payment rates. Check your Medicare Administrative Contractor (MAC) website (see list below) for 2014 payment schedules effective Jan. 1. If applicable, you may also wish to visit private insurance carrier websites for information about their 2014 payment rates.
Due to provisions of the Budget Control Act of 2011, known as sequestration, and the Bipartisan Budget Act of 2013, all health care providers face an additional 2 percent cut to Medicare payments annually for the next 12 years. The sequestration cut is not reflected in the fee schedules provided by MACs because the 2 percent reduction must be applied to the provider’s final payment amount and does not factor into the MAC’s allowed amount for the service furnished.
The MAC fee schedule shows the payment allowed for a particular service. The final payment amount from Medicare reflects the MAC’s allowed payment amount minus any deductibles and co-pays, along with the 2 percent sequestration reduction.
The Bipartisan Budget Act averted a 24 percent across-the-board cut to Medicare provider payments until March 31, 2014, and included a 0.5 percent payment increase for Medicare services that will help offset the 2 percent sequestration decrease for the first three months of 2014.
Medicare Administrative Contractor (MAC) list
- Cahaba GBA, LLC
- CGS Administrators LLC
- First Coast Service Options
- National Government Services, Inc.
- Noridian Administrative Services
- Novitas Solutions, Inc. (NOTE: This link is incompatible with Internet Explorer 11.)
- Palmetto GBA
- Wisconsin Physicians Service