The U.S. Centers for Medicare and Medicaid Services (CMS) has authorized hospitals to receive special payments under the Outpatient Prospective Payment System (OPPS) for three additional drugs and four additional services as new technologies in the outpatient setting.
Both types of payments are temporary until there is sufficient cost data from outpatient services to develop an appropriate price within the OPPS, CMS said.
The new technologies receiving reimbursement are:
- The insertion of a special device for measuring and monitoring acid levels associated with gastroesophageal reflux disease (GERD), which will be paid at $450;
- A procedure using a laser device that vaporizes the prostate and controls bleeding before and after the procedure, which will be paid at $3,750;
- The concurrent or immediate placement of a balloon catheter in the breast for interstitial radiation therapy following a partial mastectomy, which will be paid at $2,750; and
- The delayed placement of a balloon catheter into the breast for interstitial radiation therapy following a partial mastectomy, which will be paid at $3,250.
The new payment rates were included in a quarterly update to the outpatient payment system, according to CMS. The update also clarifies billing and payment issues affecting intensity-modulated radiation therapy (IMRT) and brachytherapy devices used in cancer treatment, the agency said.
By AuntMinnie.com staff writersApril 6, 2004
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