Physicians and advanced practice providers (APPs) may be eligible for a temporary Medicaid pay increase for certain evaluation and management (E/M) and vaccine administration services provided in 2013 and 2014. Chris Rasch, the Wisconsin Medical Society’s director of state and federal relations, will discuss eligibility and attestation for this pay hike during a complimentary webinar next week.
The one-hour webinar, Medicaid Primary Care Rate Increase Update, begins at noon Friday, October 25. Although there is no cost to participate, registration is required via the Society’s Continuing Education Center.
To receive the estimated 78 percent retroactive pay before the end of the year, physicians and APPs must attest by October 31. Those who attest in November and December will not receive the retroactive pay until next year, and those who attest on or after January 1, 2014, will forfeit the estimated 78 percent retroactive pay increase for qualifying services provided in 2013.
An eligible physician is one who specializes in general internal medicine, family medicine or general pediatrics or an included subspecialty as defined by the American Board of Medical Specialties (ABMS), American Board of Physician Specialties (ABPS) or American Osteopathic Academy (AOA) by fulfilling at least one of the following:
- Certification from an ABMS, ABPS or AOA member board.
- 60 percent of services provided in the last calendar year (or prior month for newly eligible physicians) are billable under CPT codes 90460-90749 and 99201-99499.
Please note that physicians in more than 40 subspecialties may qualify for this two-year pay increase. Rural Health Clinics and Federally Qualified Health Centers are not eligible, per the Centers for Medicare & Medicaid Services (CMS) final rule.
The increases apply to certain E/M and vaccine administration services with dates of services from January 1, 2013, through December 31, 2014.
Additional information about eligibility and attestation for physicians, including hospitalists, and APPs is in ForwardHealth Update 2013-44.
Back to October 17, 2013 Medigram