Congress passes one-year SGR fix as part of fiscal cliff legislation

On Tuesday, Congress passed The American Taxpayer Relief Act of 2012, to avert the “fiscal cliff.” President Obama signed the legislation on Wednesday. In addition to various tax and spending measures, the legislation includes provisions of direct importance to medical group practices. The legislation:

  • Prevents the Medicare physician payment SGR cut for one year. It eliminates the 27 percent Medicare physician payment cut, which took effect today and replaces it with a “zero percent update” to the Medicare physician fee schedule conversion factor for 2013. As has occurred with prior temporary extensions of this kind, this is not a fee schedule rate freeze. It means any conversion factor adjustments and RVU changes contained in the final fee schedule rule for 2013 may result in payment rate changes, but the massive SGR cut is nullified for a year.
  • Turns off the January 2, 2013 sequester for two months. This prevents various defense and other automatic cuts from occurring, including an across the board, two percent cut for all Medicare providers. It’s expected Congress will revisit issues related to the sequester in the near future.
  • Extends the Medicare 1.0 work RVU GPCI floor through December 31, 2013.
  • Increases the Medicare Part B equipment utilization assumption for advanced imaging services to 90 percent effective for fee schedules established for 2014 and subsequent years, thus reducing future payments.
  • Extends the Medicare therapy cap exception process through December 31, 2013.
  • Increases the Medicare therapy service multiple procedure payment reduction from 25 to 50 percent effectiveMedicare-SGR1 April 1, 2013.


This information has been provided as a summary of the provisions included in the American Taxpayer Relief Act. Please contact our office at (239) 433-5554 if you have questions regarding this information and how it will impact your specific situation
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