CMS corrects codes, raises MPI, CT fees

The U.S. Centers for Medicare and Medicaid Services (CMS) on May 6 issued a correction to its previously announced codes for the Medicare Physician Fee Schedule for 2010, with the end result being higher reimbursement for SPECT myocardial perfusion imaging (MPI) and cardiac CT scans.

The corrective actions are retroactive to January 1, 2010, and result in payment increases for myocardial perfusion imaging CPT codes 78451-78454 and CT of the heart CPT codes 75571-75574.

According to the American Society of Nuclear Cardiology (ASNC), the CMS decision hikes payments for myocardial perfusion imaging between 16% and 105%, depending on the CPT code, compared to previous 2010 rates. The reimbursement rate gains are due primarily to higher practice expense relative value units (RVUs) used to calculate reimbursement rates for procedures.

The American College of Radiology (ACR) also cited technical errors in the malpractice RVUs for certain codes, primarily due to the assignment of risk factors associated with technical component services and the assignment of risk factors to selected codes that were inconsistent with the policies published in the final rule.

ASNC, SNM, and the American Medical Association (AMA) met with CMS officials earlier this year to discuss errors made during the transition from 2009 codes for myocardial perfusion imaging to the new codes for these services in 2010.

Related Reading

CMS proposes change to PET restriction, May 7, 2010

CMS proposes 2011 inpatient payment rates, April 20, 2010

CMS offers reprieve to SGR rate cuts, March 31, 2010

CMS delays PECOS implementation until 2011, February 18, 2010

CMS cuts SPECT MPI payments 36%, sets CCTA rates, November 5, 2009

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