Medicare Forecast
Looking Good

O verall, the reimbursements will be increasing for dermatology, explains Inga Ellzey, columnist for Skin & Aging’s “Coding Corner.” “Dermatologists are going to do well again in 2005,” says Ms. Ellzey who is an expert on dermatology coding, documentation and reimbursement. Several years ago, Congress passed a law that mandated a 1.5% increase for 5 years — 2005 is the third year that this increase has been in place. So far, so good. “I don’t see anywhere where dermatologists are getting really hit,” Ms. Ellzey comments. Taking a Closer Look For many services, reimbursement percentages are expected to increase more than the proposed 1.5% in 2005. According to Ms. Ellzey, who evaluated some of the most common procedures dermatologists perform, here are some of the top proposed percentage increases. 1. 99212 - Office/outpatient visit, established, Level 2. Reimbursement will increase by 3.51%. 2. 99201 - Office/outpatient visit, new, Level 1. Reimbursement should jump by 2.57%. 3. 99213 - Office/outpatient visit, established, Level 4. It’s proposed that reimbursement will be up by 2.23%. 4. 17000 - Destruction benign/premalignant lesion. Reimbursement is expected to jump by 2.14%. 5. 11642 - Excision face - malignancy plus margins 1/1-2 cm. Dermatologists can expect an increase of 2% in reimbursement for this procedure in 2005. Patients Paying More If anything, it’s patients who will be bearing more of a burden in 2005. The outpatient care deductible was raised for the first time in more than a decade, according to Ms. Ellzey. The deductible went from $100 a year to $110. Dermatologists Could be Doing Even Better Truthfully, though, says Ms. Ellzey, even if Medicare didn’t increase reimbursements at all, doctors could still make out well by managing their costs. “Most physicians don’t have budgets. They don’t know how much they pay for suture material and other supplies,” she says. “Most doctors just need to spend some time researching their costs and tightening the boot straps where necessary. They could be doing a whole lot better despite whatever Medicare decides to do that year.” Larisa Hubbs Executive Editor lhubbs@hmpcommunications.com