which includes an analysis and payment calculations for the new Remote Therapeutic Monitoring (RTM) CPT codes issued by the American Medical Association (AMA) late last year. As announced inearlierthis year, these codes may enable indirect reimbursement for digital...
The Centers for Medicare & Medicaid Services (CMS) has issued the 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems Proposed Rule with information regarding coding and reimbursement for the use of the eCoin tibial neurostimulator ...
Together with the RPM codes introduced by CMS earlier, the RTM codes give healthcare providers more opportunities for reimbursement in remote patient monitoring programs, both in data collected and in who’s able to collect and use that data. But experts who’ve analyzed the propos...
Open surgical implantation of cuffs for vagus nerve stimulation (CPT 64568) and hypoglossal nerve stimulation (CPT 64582) has the highest reimbursement, around $34,000. Implantation of any PNS IPG (CPT 64590) is reimbursed at $610, covering only IPGs that are separable from the leads (such ...
CMS Establishes Reimbursement Pathway for Virtual Reality Program CMS created the first HCPCS Level II code for a virtual reality program, characterizing it as durable medical equipment and creating a pathway for Medicare and commercial payer coverage....
In the final rule, to qualify for reimbursement under CPT codes 99457 and 99458, CMS mandated at least 20 minutes of interactive communication time between provider and patient over a calendar month, but that interactive communication couldn’t be part of the 20 minutes of RPM ca...
Under PHE waivers, CMS allowed separate reimbursement of telephone (audio-only) E/M services (CPT codes 99441-99443), something embraced by many practitioners and patients, particularly patients in rural areas or without suitable broadband access, as well as patients with disparities in access to ...
(Mo-99), the precursor to Tc-99m, CMS proposes a new $10 add-on payment per dose, beginning Jan. 1, 2026, for radiopharmaceuticals using Tc-99m derived from domestically produced Mo-99. This initiative aims to ensure equitable reimbursement for providers, reflecting the higher costs of...
providing a remedy for the reduced 340B payments hospitals received from 2018 through Sept. 27, 2022, the date on which CMS restored reimbursement for 340B drugs to the full OPPS rate. (See Holland & Knight's previous alert, "CMS Issues Final Rule Remedying Underpayments to 340B Covered ...
Category I CPT Codes 669X2 and 669X1 will replace Category III codes 0191T and 0376T as the primary codes that physicians will use to seek reimbursement utilizing Glaukos’ trabecular micro-bypass technologies (iStent, iStent inject, iStent inject W) when used as approved in combination with ca...