Pathology services see neutral overall adjustment in Proposed 2020 MPFS

July 30, 2019

After a significant delay, CMS released its Proposed 2020 Medicare Physician Fee Schedule Monday evening. Its release marked the longest delay in the rule’s annual release since 2006, when it was held from public view until August of that year.

Unfortunately, a quick analysis of expected allowed charges across specialties shows that CMS intends to keep overall payment adjustments for pathology and independent lab services mostly neutral, with those specialties set to receive 0% and 1% adjustments, respectively. The biggest cuts will again impact payments for additional flow cytometry markers and the technical component of prostate biopsies, two areas CMS has continued to target for significant reductions in recent fee schedule updates.

In terms of positives, both the global and technical component of 88305 are proposed to receive small pay hikes, while several other high-volume services are proposed to receive neutral or small positive adjustments.

The proposed conversion factor for 2020 is $36.09, a slight bump over the finalized 2019 rate of $36.04.

Finalized rates are expected to be announced in the fall, with rate changes taking effect Jan. 1, 2020. For more information on specific rate updates, please refer to the chart below.

Proposed 2020 Medicare Physician Fee Schedule:

*All prices calculated using the proposed 2020 conversion factor of $36.09.

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