For Immediate Release from American Pathology Foundation 

November 2, 2012

 On Thursday, November 1, The Centers for Medicare and Medicaid Services (CMS) announced the 2013 Physician Fee Schedule and a number of pay cuts which will affect the practice of pathology.

The 2013 Physicians Fee Schedule will be published in the Federal Register on November 16 and take effect on January 1.  Physician payments may further decrease by 27% under the Sustainable Growth Rate (SGR) reimbursement formula unless Congress decides to once again delay these cuts.

 CMS lowered the technical component (TC) of the surgical pathology code 88305 by 52%.  Assuming that the Conversion Factor remains at the 2012 level, this will mean an approximate 33% reduction in the global billing amount for the 88305. This includes the impact of the 2% increase in the Professional Component.  Further, CMS announced that the newly developed CPT molecular pathology codes would be placed on the Medicare Clinical Laboratory Fee Schedule (CLFS).

 In an effort to reduce health care costs as dictated by health care reform law, CMS is examining and adjusting high volume codes from all specialties. The technical component of the 88305 code was last reviewed in the year 2000.