This isn’t good news folks. CV medicine payment will be flat or even slightly reduced for many members next year in the exceptional economic times, given CMS' final rule on the 2009 Medicare physician payment schedule. Here’s how it shakes out: when the various changes in payment rates for services are combined, AMA estimates that specialties including infectious disease, psychiatry and emergency medicine will benefit most, with an average increase of 4 percent. Anesthesiologists, cardiac surgeons, colorectal surgeons, intensivists, family physicians, gastroenterologists, general surgeons, geriatricians and internists also will see a 2 percent – 3 percent increase. Cardiologists, on the other hand, are among a group that will experience an average decrease of 1 percent – 2 percent.

There is a way to offset that -- move to e-prescribing (2%+), and participate in PQRI (2%+).  Those decisions would add a 4% increase in Medicare reimbursement, and move the overall net to an increase of 2-3%. We are strongly advocating at minimum a 7% increase for PQRI reporting in the future (hopefully a ‘turbocharged’ PQRI that is compatible with the IC3 program).

Note that E & M codes will go up for everybody -- so cardiologists who do a lot of outpatient E & M care will see increases, whereas interventionalists and imagers will likely do fewer E & M care.

We can submit public comments until Dec. 29, but, let’s face it, except for educating CMS, they won’t do us much good for 2009. It’s 2010 that we need to get busy on strategizing on and preparing to advocate for.