URGENT RESPONSE TO CMS NEEDED

The Centers for Medicare and Medicaid Services (CMS) is moving towards decreasing reimbursement for complete diagnostic ultrasounds (93970) to the same level as a limited ultrasound (93971).  Currently they are in the process of grouping these two services in the same Ambulatory Payment Classification (APC).  If this happens ambulatory surgery centers, independent testing facilities and other facility based providers will see a reduction of nearly $75.00 for the full diagnostic study.

 

This will not impact the individual/group provider that is rending care in an office (Place of Service 11).  At least not yet.  The concern is that once CMS is able to reimburse these services at a lower rate for the facility based care, they will then lower the reimbursement rates for all providers including office based providers.

 

When you couple this with the reductions in reimbursement that occurred a few years back and the rising costs in ultrasound machines, RVT’s, office space, etc.; it is imperative that we all reach out to CMS now before it is too late.  You can submit your commentary by writing to CMS by September 11th (sorry for the short turn around on this… we just found out as well).  You can submit your comments by going to:

 

http://www.regulations.gov 

 

Search for: CMS-1678-P

 

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Program will appear.

 

Click on Comment Now.

 

Upload your comments, fill in the rest of the information and send.

 

If we generate enough information to CMS noting how extensive and different the full and complete diagnostic US is as compared to the limited study, perhaps they will actually listen.

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