You knew it was coming: Now it's here - 2005 - a switch to sales pricing methodology and drastically reduced fees for prostate cancer drugs

Why This Topic Matters

The changes discussed can materially affect practice revenue, billing workflow, and code selection for commonly used urology drugs and injection services. Readers will want to know what parts of the Medicare fee schedule changed, which temporary codes were introduced, and which existing codes were affected.

Article Sections

1. Medicare 2005 fee schedule overview

   Introduces the upcoming payment year and summarizes the general impact on reimbursement for urology-related drugs and services. It also notes the source of the fee schedule update.

2. Drug pricing methodology change

   Describes the shift in Medicare drug pricing methodology for 2005 and its broader effect on payment for selected therapies. The discussion is framed around changes relevant to prostate cancer drugs and other commonly used urology products.

3. Temporary G codes for injection administration

   Explains the introduction of interim Medicare G codes for drug administration and how they relate to existing billing practices. The section addresses the transition period before later CPT updates.

4. Payment examples and affected drugs

   Presents a table of selected urology drugs and their projected payment changes for the new year. The material compares reimbursement amounts across time and highlights the scope of the payment adjustments.

5. Long-acting implants and unlisted code discussion

   Covers longer-term implant therapies and a separate unlisted-code billing issue mentioned in the article. It also places these items in the context of the broader fee schedule changes.

6. Urology injection fees and codes for 2005

   Compares prior injection coding with the new temporary Medicare administration codes and includes a fee comparison table. This section focuses on the transition from older billing patterns to the interim code structure.