Changes to fee schedule result in MRI payment hikes

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews a physician fee schedule update that affects MRI payment levels and adds a new HCPCS Level II drug code, along with several other fee schedule status and indicator changes. It is intended for coding and billing professionals who need to stay current on Medicare-related reimbursement updates, effective dates, and code-status changes. The article also notes administrative implementation timing and discusses selected procedure indicators and coverage status updates.

Why This Topic Matters

Fee schedule revisions can change payment amounts, claim handling, and coverage status for reported services, so coders and billing staff need to recognize which codes and policy indicators were updated.

Article Sections

  1. Fee schedule update overview

    Introduces the physician fee schedule changes described in the article and the general areas affected. It provides context for the reimbursement and code update discussion that follows.

  2. MRI code update and payment impact

    Summarizes the magnetic resonance imaging service updates discussed in the fee schedule notice and their effect on payment. The section also notes the timing of the change and implementation guidance.

  3. New drug code added to the fee schedule

    Covers the addition of a drug-related code to the fee schedule and identifies the effective period referenced in the update.

  4. Other fee schedule indicator changes

    Reviews additional procedure and coverage status updates included in the memo. These changes involve surgery indicators and restricted coverage status.

What You Will Learn

  • What types of fee schedule changes were included in the update
  • How MRI-related reimbursement was affected at a high level
  • Which broad categories of codes received new status or indicator changes
  • When the update was effective and how carriers were instructed to implement it
  • What kinds of HCFA fee schedule corrections were addressed in the memo

Who Should Read This

  • Medical coders
  • Coding managers
  • Billing staff
  • Practice administrators
  • Revenue cycle professionals
  • Medicare reimbursement specialists

Codes Discussed


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