Under a final rule from the Centers for Medicare and Medicaid Services (CMS), Medicare payments for hospital outpatient procedures will increase in 2003 by almost 6%. Payments for diagnostic mammography and colonoscopy will increase 11% and 10%, respectively.
The announced increases do not cover 2003 physician fees, which will be announced later. Colonoscopy physician fees in 2002 are $205.25. Physician fees for a unilateral diagnostic mammogram in 2002 are $35.48; for bilateral $43.44. Physician fees for screening mammography will also be changed when the final fee schedule is released.
The technical/facility component payments for mammography will go up, from this year’s $30.84 rate to $33.86 in 2003. Payments for basic flexible colonoscopy are going up, from $370.07 to $412.85 in 2003. From the hospital’s standpoint, there may be add-ons in colonoscopy for procedures such as biopsy or collection of specimens.
Virtual colonoscopy is not covered.
Medicare pays hospital outpatient departments for services based on the Hospital Outpatient Prospective Payment System (HOPPS), which establishes base payment rates for ambulatory payment classifications (APCs). The new rule also establishes an APC for procedures that use drug-eluting stents if the Food and Drug Administration approves their use.
By AuntMinnie.com staff writersNovember 5, 2002
Related Reading
AMA warns of "catastrophe" if Medicare payment problem not fixed, October 16, 2002
HOPPS won't improve without feedback from radiologists, September 12, 2002
Medicare payment bill high on U.S. Senate agenda, September 4, 2002
CMS’ proposed 2003 payment rates bode ill for breast procedures, August 12, 2002
CMS proposes 3.5% hike in 2003 outpatient payments, August 7, 2002
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