August 9, 2021

Several Spine Surgery Procedure RVUs Reviewed as Part of the Medicare Physician Fee Schedule 2022 Proposed Rule

Several Spine Surgery Procedure RVUs Reviewed as Part of the Medicare Physician Fee Schedule 2022 Proposed Rule As part of the 2022 Medicare Physician Fee Schedule proposed rule, several sets of spinal surgical procedures were included as either new to the Physician Fee Schedule or existing services that were reviewed or revalued. Specifically, CMS reviewed new codes for Arthrodesis Decompression when performed with Fusion, new codes for Basivertebral Nerve Ablation (Intracept procedure), and a revised value for Insertion of Spinal Stabilization devices (Coflex). CMS proposed updating the Relative Value Units (RVUs) assigned to Current Procedural Terminology (CPT) 22867, “Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level” (Coflex). The current […]
August 9, 2021

CMS Prior Authorization of Cervical Fusion Procedures Began in July 2021

CMS Prior Authorization of Cervical Fusion Procedures Began in July 2021 Despite continued efforts by stakeholders to eliminate or delay the implementation of Prior Authorization review in the outpatient prospective payment system (OPPS) settings for cervical fusion and spinal neurostimulator implantation procedures, the review began on July 1, 2021. With the initiation of the policy, it will be important to track and share information related to the addition of cervical fusion with disc removal and implanted spinal neurostimulators to the nationwide prior authorization process for hospital outpatient department services. This tracking will be vital for appropriate oversight to ensure beneficiary access is maintained and an efficient process is established for both providers and beneficiaries. ISASS will work to provide input to CMS and […]
August 5, 2021

CMS Releases 2022 Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule

CMS Releases 2022 Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule On July 19, 2021, CMS published a proposed rule for the 2022 calendar year (CY) Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) settings. The OPPS/ASC Schedule sets the annual payment rates, policies, and regulations related to Outpatient Facilities and Ambulatory Surgical Centers. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) proposed Medicare payment rates for hospital outpatient and Ambulatory Surgical Center (ASC) services. The CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and ASC Payment System Proposed Rule is published annually and will have a 60-day comment period, which will end on September 17, 2021. The final rule with comment period […]
August 5, 2021

CMS Releases 2022 Medicare Physician Fee Schedule Proposed Rule

CMS Releases 2022 Medicare Physician Fee Schedule Proposed Rule On July 13, 2022, CMS published a proposed rule for the 2022 calendar year (CY) Medicare Physician Fee Schedule (PFS). The Medicare Physician Fee Schedule sets the annual payment rates, policies, and regulations related to physician practices. Comments in response to the letter will be due September 13, 2021. Since 1992, Medicare payment has been made under the PFS for the services of physicians and other billing professionals. Physicians’ services paid under the PFS are furnished in a variety of settings, including physician offices, hospitals, ambulatory surgical centers (ASCs), skilled nursing facilities and other post-acute care settings, hospices, outpatient dialysis facilities, clinical laboratories, and beneficiaries’ homes. Payment is also made to […]