Reimbursement: CMS Avoids Coverage For Substance Abuse Codes

Why This Topic Matters

The article matters because Medicare coverage decisions can directly affect whether practices can be paid for newly introduced services. It also highlights how CMS may respond to new CPT reporting categories by limiting payment, creating temporary HCPCS codes, or applying national noncoverage policies.

Article Sections

1. CMS 2008 Fee Schedule and payment decisions

   An overview of the Medicare fee schedule update and its effect on newly released professional service codes. The section frames the broader reimbursement impact for affected practices.

2. Cardiology coverage changes

   Discussion of CMS coverage treatment for selected cardiovascular imaging and device-related services. The section covers how the agency categorized certain new cardiology billing items within the Medicare program.

3. Impact on cardiac MRI reporting

   A practical discussion of how the coverage decisions affect reporting and documentation for the cardiac MRI code family. The section addresses reimbursement implications for the affected service group.

4. Substance abuse screening and assessment codes

   An explanation of CMS handling of new substance-abuse-related screening and assessment billing items. The section also discusses the agency's use of temporary HCPCS G codes in this area.

5. Provider commentary on the policy change

   Brief remarks from industry sources on the unusual nature of the coverage approach. The section offers perspective on how the policy may affect billing and coding operations.