decisionhealth Newsletters, Part B News - 2006 Issue 7 (July)
Congress eyes better pay ideas for administered drugs
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Article Overview
This article covers congressional and CMS-related discussion about Medicare reimbursement for physician-administered drugs and the coding used for administering them. It summarizes stakeholder testimony on payment methodology, the timing of updated reimbursement rates, the Competitive Acquisition Program, and the need for more specific administration and planning codes. It is relevant to medical coders, oncology practices, specialty providers, and reimbursement staff tracking federal payment policy.
Why This Topic Matters
Medicare payment methodology and administration-code structure can affect reimbursement accuracy, access to therapy, and how physician practices document and bill drug-related services.
What You Will Learn
- How Congress and CMS are discussing Medicare payment policy for administered drugs
- Why stakeholders are seeking changes to drug payment calculations and rate updates
- What concerns were raised about the specificity of drug administration coding
- How the Competitive Acquisition Program and IVIG-related services fit into the discussion
Who Should Read This
- Medical coders
- Coding auditors
- Oncology billing staff
- Specialty practice administrators
- Reimbursement professionals
- Physician offices
- Health policy readers
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