10% Pain Medicine Medicare Cuts

[stim4u]

After discussing with a couple members on this forum, it has come to our attention that Medicare carriers have cut pain medicine codes (ie. 62311/10, 64483/84, RFA) by ten percent since 1/08. We have seen this in at least two states with different medicare carriers. Has anybody else seen this cut, and why has it not been implimented to other medical fields (ie. cardiology, GI, etc). I have been trying to contact my carrier for an explanation, with no luck.

Any info would be appreciated.

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[Doctodd]

looking at some eob's in front of me with both 2007 and 2008 claims, here is what im getting in Miami-Dade county for a couple of codes....

Date...........CPT.........Prov Pd
9-07-07.....64475 L.......238.14
................64475 R.......181.04
................77003..........23.17

2-25-08.......64475 R......215.74
..................64475 L........107.87
..................77003...........23.46

so.....fluoro went up by 30cents....but my facets went down significantly, especially the opposite side. Which is why most docs have them come back the next day or next week.

 

[Tenesma]

thanks for pointing that out

i have noticed that my medicare carrier has dropped reimbursements for procedures since 01/08 by about 2-5$ per code ----

not as significant as what you guys are seeing...

very interesting

i thought we were supposed to see a 0.5% increase in payments in 01/08

 

[tchoupdoc]

i thought we were supposed to see a 0.5% increase in payments in 01/08[/quote]

My understanding was that this was an average across all specialties, not that everyone would get this.

I am the first to admit if I am wrong, but I also believe that center for medicare services has a "pie" for every set of cpt's. It's a zero sum game. So as more an more 64483's/77003's are submitted, then everybody's slice gets skinnier. In other words, the more providers there are, the less everyone gets paid, at least by the gov't providers.

 

[lord_jeebus]

I am the first to admit if I am wrong, but I also believe that center for medicare services has a "pie" for every set of cpt's. It's a zero sum game. So as more an more 64483's/77003's are submitted, then everybody's slice gets skinnier. In other words, the more providers there are, the less everyone gets paid, at least by the gov't providers.

So if everyone worked less, they'd get paid the same as they do now, and after factoring in the cost of equipment and such, would take home more at the end of the day!