Medicare Global Package Proposed Change

The 2015 Physician Fee Schedule Proposed Rule, published in the July 11 Federal Register, includes a proposal (section II.B.4) to transition all CPT codes currently assigned a 10-day global period to a 0-day global period in 2017. Codes assigned a 90-day global period would transition to a 0-day global period in 2018.

The impact of this significant change could be broad and substantial in many ways. The reimbursement structure for surgical procedures will of course change altogether, with the surgeon foreseeably receiving less per procedure on the front end and creating more required billing processes during the post-op period. It could potentially change utilization by shifting post-op visits from the surgeon to other providers such as primary care providers.

This will certainly have an impact on RVU’s as the post-op follow up code of 99024 that currently has no RVU value associated with it will become obsolete. This should positively impact providers in regard to the RBRVU methodology.

Under Medicare Part B, patients may have out-of-pocket costs (20% co-insurance plus potential deductible) that they would not have incurred under the existing global package.

AHDPG^TM will continue to monitor this proposed rule and offer insight as this change develops.