Temporary Extension Act of 2010" Extends the Zero Percent Medicare Physician Fee Schedule Update and the Therapy Cap Exception Process

On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.” Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010. Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment. Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

In addition, the new law extends through March 31, 2010, the exception process for therapy claims reaching the annual cap, retroactive to January 1, 2010. Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions.

Please watch your listserv and contractor’s website for more information about the new legislation.

CMS JSM-10168
March 3, 2010

As a J10 A/B Medicare Administrative Contractor for Alabama, Georgia, and Tennessee, we process claims for physician services as defined by the Center for Medicare & Medicaid Services (CMS) in the Internet Only Manual (IOM) Chapter 5, Section 70. We are also currently the Part B Carrier for the state of Mississippi.

Some services include but not limited to:

Physician services (including podiatrists, chiropractors, optometrists)
Ambulance services
Independent Clinical Laboratories
Independent Diagnostic Testing Facilities (IDTFs)
Non-physician Practitioners (Nurse Practitioners (NPs), Physician Assistants (PAs), Certified Registered Nurse Anesthetists (CRNAs), Certified Nurse Midwives (CNM), Licensed Clinical Social Workers (LCSWs), Clinical Psychologists (CPs)

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