Late on October 31, 2014, CMS released the final Medicare physician fee schedule for 2015. Notably for AAHKS members, CMS is holding the work relative values for total hip arthroplasty and total knee arthroplasty at the 2014 interim values. In other words, as AAHKS recommended, CMS is not imposing additional cuts to bring the values to the level recommended by the AMA/Specialty Society Relative Value Update Committee (RUC). CMS notes in a fact sheet that “the agency decided further reductions were not warranted after considering the public comments.” CMS has adopted changes to the process for valuing new, revised and potentially misvalued codes to increase transparency, with a transition in CY 2016 and full implementation in CY 2017.

With regard to the Sustainable Growth Rate (SGR), the Protecting Access to Medicare Act of 2014 provides for a zero percent update for services furnished between January 1, 2015 and March 31, 2015. CMS estimates, however, that the SGR will reduce fee schedule rates by an average of 21.2 percent on April 1, 2015 if Congress does not act.

The advance version of the rule and the fact sheet are posted on the website of the Office of the Federal Register. We will be providing additional analysis of the rule for AAHKS members in the future.