HHS last week recommended a single Medicare physician payment base for 1997 and an update in physician fees of 0.8%.
The actions raised the possibility that Congress may consider a bill making small revisions to the Medicare physician payment formula before it adjourns this fall.
Under the HHS proposal, the single payment base, called the conversion factor, would be $35.70 in 1997. That would represent an increase for primary care but a drop for surgery.
To establish fees, the conversion factor is multiplied by a work-based numerical value assigned to each service performed for a Medicare beneficiary. Conversion factors in 1996 are $40.80 for surgery, $35.42 for primary care and $34.63 for all other services.
Without legislation, however, a default formula would take effect to increase the conversion factor for surgery to $41.66 and primary care to $36.38 but reduce it for all other services to $34.42.
Nonsurgical procedures account for nearly three-fifths of all Medicare physician expenditures.
HHS' proposal joins those of the Physician Payment Review Commission and Congress, which have endorsed a single conversion factor. The American Medical Association also wants a single conversion factor, although it recommends a three-year transition beginning in 1997.
While Congress almost surely will avoid comprehensive restructuring of Medicare before it adjourns this autumn, it still could debate a bill making technical revisions.
Some policy experts said HHS' recommendation of a single conversion factor, along with some possible revisions to the hospital prospective payment rates that take effect Oct. 1, could heighten interest in a Medicare technical revisions bill.