Part B Payment: It's Early in the Year-- And CMS Is Already Changing Its Fee Schedule

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

Article Overview

This article reviews a set of CMS fee schedule changes announced early in the year and explains the general categories of Medicare Part B updates they affect. It is aimed at coders, billers, and reimbursement staff who track payment indicators, code status changes, and code additions or discontinuations across CPT and HCPCS Level II. The coverage includes revised surgical and payment indicators, global days changes, discontinued vaccine and procedure codes, and a newly introduced HCPCS code discussed in CMS MLN Matters guidance.

Why This Topic Matters

These CMS updates can affect how claims are paid, whether services remain payable, and how certain procedures are treated under Medicare Part B. Staying aware of the changes helps billing teams monitor fee schedule impacts and maintain accurate claim processing.

Article Sections

  1. Look for Higher Co-Surgery Payment For This Code

    Discusses a CMS update to payment indicators affecting a procedure code under the Medicare fee schedule. The section focuses on how the change may alter reimbursement treatment for co-surgery reporting.

  2. Check Out Discontinued CPT and HCPCS Codes

    Covers codes CMS says will no longer be paid after specified dates of service and describes the broad categories of discontinued services and supplies. It also references associated MLN Matters guidance.

  3. New Botox Code Makes Debut

    Introduces a newly added HCPCS code and notes its CMS status indicator under Part B. The section points readers to related MLN Matters material for additional background.

What You Will Learn

  • Which broad types of Medicare Part B fee schedule changes CMS announced
  • How CMS updates can affect payment indicators and global period assignments
  • What kinds of CPT and HCPCS codes were discontinued in the update
  • How CMS described the addition of a new HCPCS code under Part B
  • Where CMS linked related MLN Matters guidance for further review

Who Should Read This

  • Medical coders
  • Medical billers
  • Revenue cycle staff
  • Practice managers
  • Compliance staff
  • Reimbursement specialists

Codes Discussed

  • CPT: 57155
  • CPT: 64613
  • CPT: 64614
  • CPT: 77071
  • CPT: 93464
  • CPT: 31579
  • CPT: 92511
  • CPT: 90470
  • CPT: 90663
  • HCPCS Level II: Q1003
  • HCPCS Level II: S2270
  • HCPCS Level II: S2344
  • HCPCS Level II: S3905
  • HCPCS Level II: Q2040

Code Ranges Discussed

  • CPT: 64613-64614
  • CPT: 93464-26

Modifiers Discussed

  • CPT: 26

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