decisionhealth Newsletters, Part B News - 2006 Issue 11 (November)
Alert: Carriers to set your cardiac cath TC fees in ‘07
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Article Overview
This article explains a Medicare payment update affecting certain technical component and global services, especially in the cardiac catheterization and echo-guidance space, and notes that carriers may set pricing in place of CMS for some services in 2007. It also includes a table of high-volume procedures with major work RVU changes between the proposed and final 2007 physician fee schedule rules. The piece is useful for billing staff, coders, and physician practices that track fee schedule changes, carrier pricing, and work RVU impacts.
Why This Topic Matters
The article helps readers understand which services may require carrier-determined pricing and highlights fee schedule changes that can affect planning, claim submission, and revenue forecasting for 2007.
Article Sections
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Carrier pricing for technical component and global services
Discusses a Medicare payment update in which carriers may determine rates for selected services in 2007. It also notes the practical context for practices that bill these services and need to monitor local payment policies.
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Example and association guidance
Provides a billing example and summarizes general guidance from a specialty organization about checking with carriers and providing pricing information when available. It also describes how practices were advised to monitor local rates.
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Highest billed codes with major work RVU changes
Presents a table comparing proposed and final 2007 physician fee schedule work RVUs and payment changes for a set of high-volume procedures. The section is a summary of fee schedule impact across multiple specialties.
What You Will Learn
- How certain Medicare technical component services were handled for 2007 payment pricing
- What types of services were affected by carrier-set rates versus fee schedule payment
- How to interpret a summary table of work RVU changes and payment impact
- Which organizations were referenced for carrier outreach and monitoring
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician reimbursement specialists
- Cardiology practices
- Hospital-based physician groups
Codes Discussed
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