E/M Coding Alert - 2005 Issue 39
REIMBURSEMENT: CMS Puts Bundling Of Casting Supplies On Hold
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Article Overview
This Find-A-Code article covers a CMS reimbursement update affecting multiple Medicare payment and coverage areas. It is most relevant to billing professionals, coders, compliance staff, oncology practices, orthopedic practices, and other providers tracking annual fee schedule changes. The article gives a broad overview of policy areas discussed in the final rule, including a new oncology data-collection project, changes to the Competitive Acquisition Program for Part B drugs, the decision not to bundle certain casting supplies, a delay in practice expense payment changes, screening expansion, temporary IVIG supply payment, and telehealth additions.
Why This Topic Matters
The article highlights Medicare policy shifts that can affect payment workflows, coverage awareness, and practice operations across several specialties. Readers need the full article to understand which changes are temporary, which are delayed, and how CMS is structuring its new reimbursement and reporting initiatives.
Article Sections
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Oncology demonstration project and new CMS reporting initiative
Summarizes the transition from an expiring chemotherapy demonstration project to a new CMS project for the following year. The section discusses the general reporting themes and the role of evidence-based review.
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CAP revisions
Describes revisions to the Competitive Acquisition Program for Part B drugs and related operational changes for vendors and practices. It also notes CMS clarification on pricing methodology within the program.
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Casting
Covers CMS’s decision regarding proposed bundling of casting and strapping supplies and the related payment impact for orthopedic practices.
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PE-RVU changes
Explains the delay in implementation of practice expense relative value unit changes and the reason CMS gave for postponing the policy.
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Glaucoma screening
Notes an expansion of a Medicare screening benefit to a broader eligible population.
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IVIG supplies
Summarizes a temporary add-on payment related to intravenous immune globulin supply acquisition during shortages.
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Telehealth
Describes an expansion of telehealth coverage to include additional medical nutrition therapy services starting the following year.
What You Will Learn
- The Medicare payment and coverage topics addressed in the CMS final fee schedule rule
- How CMS is approaching oncology demonstration reporting and data collection
- Which payment and benefit areas were revised, delayed, expanded, or left unchanged
- The general types of operational impacts described for specialty practices
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Practice managers
- Oncology practices
- Orthopedic practices
- Medicare reimbursement professionals
Code Ranges Discussed
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