Reminder: July 1 Increase in Medicare Part B Rates

This is a reminder regarding the mandated 0.5 percent increase in Medicare Part B rates effective July 1, 2015. 

LeadingAge NY provided members with a detailed analysis of the “Doc Fix” measure as signed into law this past April (H.R. 2 The Medicare Access and CHIP Reauthorization Act of 2015).  Among other things, this measure repealed the Sustainable Growth Rate (SGR) formula based methodology for determining annual updates to the Medicare Physician Fee Schedule (MPFS). The MPFS determines Medicare Part B rates paid to physicians and other practioners, along with the rates paid to nursing homes and home care providers for ancillary services. 

Without this measure in place, providers would have incurred a 21.2 percent reduction in Medicare Part B rates effective April 1.  Instead, Part B rates for the second quarter of 2015 remained unchanged and increased by an average 0.5 percent effective July 1.  

LeadingAge has updated their Medicare Part B rate calculation tool for July 1 with a revised conversion factor of $35.9335, increased from the factor of 35.7547 used for MPFS rates during the first half of 2015.

To access the new rate tool you need to log into the LeadingAge web site at www.leadingage.org and click on “Members”, then “Nursing Homes”, and then “Payment and Finance” where you will find a link to the 2015 Medicare Part B Therapy Rates (Final) – Update with Conversion Factor.  If anyone has difficulty accessing the tool, please contact me for assistance.

Also, please remember that New York is divided into the following payment localities for MPFS rates:

You should be sure to select the correct locality on the drop down menu found on the rate calculation tool.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827