Mammography exams in the U.S. may be up for another reimbursement boost, ranging from 15% for bilateral diagnostic exams to 18% for unilateral tests. The Centers for Medicare and Medicaid Services (CMS, formerly HCFA) is in the middle of its regular five-year review of physician work value units and physician schedule fee -- and the Relative Value Update Committee (RUC) has initially agreed to a fee hike for breast studies.
Published in the Federal Register on June 8, 2001 (Vol.66:11. pp. 31027-31084), the RUC has recommended the acceptance of changes in current procedural terminology (CPT) codes as proposed by the American College of Radiology.
According to the Federal Register, the ACR has identified codes that it believes are "undervalued… work [relative value units] for two mammography procedure codes (codes 76090 and 76091) are not reflective of the amount of physician work necessary to perform all the requirements for the government-regulated procedures and ACR standards. The level of quality control and quality assurance requirements instituted by the Food and Drug Administration (FDA) and Mammography Quality Standards Act of 1992 (MQSA) have increased the level of physician time outside of the direct patient care time."
The final rule on the 2002 Medicare Fee Schedule is scheduled for release in November 2001.
By AuntMinnie.com staff writersAugust 2, 2001
Related Reading
U.S. senators introduce bill to raise screening mammography payments 30%, March 19, 2001
Harkin will introduce bill to raise screening mammography payments, February 6, 2001
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