decisionhealth Newsletters, Answer Books - 2010 Issue 7 (July)
Pumps and Ports / Medicare payment for implantable pump codes 95990, 95991
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Article Overview
This article discusses Medicare billing and payment policy for implantable pump refill and maintenance services in different care settings. It is aimed at coders, billing staff, and clinicians who need a quick understanding of how CMS and Medicare distinguish between physician-performed and facility-based service payment. The piece focuses on general payment treatment, office versus facility context, and related Medicare terminology.
Why This Topic Matters
Understanding Medicare’s payment treatment for implantable pump services helps avoid billing errors and confusion about where the service is payable. It is especially relevant for practices and facilities that perform pump refills or maintenance and need to align claims with Medicare policy.
What You Will Learn
- How the article frames Medicare payment policy for implantable pump refill and maintenance services.
- The difference between physician office and facility contexts discussed in the article.
- How the article relates pump service billing to broader Medicare terminology.
- How the article connects the topic to related central venous access content.
Who Should Read This
- Medical coders
- Billing staff
- Physician office managers
- Facility revenue cycle staff
- Clinicians who perform implantable pump services
Codes Discussed
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