MEDICARE 2019 FINAL RATES

The Centers for Medicare and Medicaid Services (CMS) just posted the new Medicare fee schedule for 2019.  There are a number of changes that will impact the phlebology physician.  Please keep in mind that any allowed amounts you receive will be different (up or down depending on geographic area)from the ‘national average’ rate listed below.

 

RF Ablation – 36475 – $1,463.19 or a 5.6% decrease

2nd Access – 36476 – $308.13 or a 2.4% increase

 

Laser Ablation – 36478 – $1,156.86 or a 6.4% decrease

2nd Access – 36479 – $325.43 or a 2.4% increase

 

VenaSeal – 36482 – $2,089.91 or a 3.3% decrease

2nd Access – 36483 – $153.53 or a 4.5% increase

 

ClariVein – 36473 – $1,492.02 or a 3.2% decrease

2nd Access – 36474 – $283.63 or a 0.1% increase

 

Varithena Single Vein – 36465 – $1,572.75 or a 3.2% decrease

Varithena Mulitple Veins – 36466 – $1,653.11 or a 2.6% decrease

 

The (primarily) decrease in reimbursement is due to a four year study during which the cost of the catheter or product to the physician has steadily dropped.

 

The above rates are Medicare’s pricing.  Many of your commercial contracts are likely following some sort of reimbursement based on Medicare, so you will see a reduction in commercial reimbursement as well.

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