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Global Surgery and 2015 Medicare Physician Fee Schedule

Contributed by Michael A. Cassidy

On July 21, 2014, I posted the proposed Medicare Physician Fee Schedule, and described the intent by CMS to eliminate global surgery.On November 13, 2014, CMS issued the final 2015 Medicare Physician Fee Schedule, and CMS incorporated the changes regarding global surgery.

Global Surgery

There are three primary categories of global surgery packages that are labeled based on the number of post-operative days included in the global period — 0-day, 10-day, and 90-day global codes:

  • 0-day — Includes the surgical procedure and pre-operative and post-operative physicians’ services on the day of the procedure, including visits related to the service;’
  • 10-day — includes the same services as the 0-day global code plus visits related to the procedure during the 10 days post-procedure; and
  • 90-day — Includes the same services as the 0-day global codes plus the pre-operative services furnished one day prior to the procedure and post-operative services during the 90 days post-procedure.

Concerned with inaccurate valuation and disparate payments associated with global surgery packages, CMS proposed transforming all 10- and 90-day global codes to 0-day global codes. Instead of receiving a single payment that includes follow-up care, physicians will bill for each individual post-surgery follow-up service. The transition for current 10-day global codes will begin in CY 2017 and the current 90-day global codes will begin in CY 2018. CMS will seek further input from stakeholders in the 2016 rulemaking cycle on this matter.

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