Deceptive fee schedule

[Stim4me]

ASIPP just posted this. They show "increases" compared to "proposed" 2017 CMS payments. But If you compare 2016 to 2017 directly, essentially all in office payment is negative. Our own society trying to deceive us?? Sad

http://files.constantcontact.com/be15115b001/d4cffa3d-9ce3-47df-867b-5e69ed8e0ecb.pdf

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Members don't see this ad.

 

[DOctorJay]

was this emailed out? it's not on their website yet and they typically don't tabulate the values this way. At least 2016 didn't look like that. Strange.

 

[Stim4me]

was this emailed out? it's not on their website yet and they typically don't tabulate the values this way. At least 2016 didn't look like that. Strange.

Emailed to me yesterday. It is a sad email and the data isn't fully inputed. Seems very lackluster and spotty from ASIPP this year...can't see how continued contributions help the pp guys.

 

[Ducttape]

if its not official, but the numbers between final 2016 and that current document seem to be correct. this does suggest a pretty significant pay reduction. maybe its an increase from the proposed, but definitely reduced across the board compared to final schedule 2016...

 

[Yo GabbaPentin]

WTF... They cut IDET reimbursement. I'm cancelling my membership.

 

[Stim4me]

WTF... They cut IDET reimbursement. I'm cancelling my membership.

Dam I wanted my Ferrari this year.... jk

 

[powermd]

I don't want to sound any alarms here, but what happened to the data for epidurals?

The CPT codes are simply MISSING from the CMS data files for both the physician and HOPD fee schedules. In the HOPD schedule, the CPTs are there, but all the weighting information used to calculate reimbursement is missing.

It's empty on Lax's table too.

In case you want to look it up, the PFS is "Addendum B - Relative Value Units and Related Information Used in CY 2017 Final Rule" CMS 1654-F.

If the codes were renumbered, does anyone know the new numbers? I don't see 62318 or 62319 either.

**update**

Okay, 62321 and 62323 are the new codes reflecting image guided ILESI C/T or L.

About a $20 bump for our practice in lumbar epidurals.

 

[nvrsumr]

I did not see 77002? Has non spine fluoro guidance been deleted?

 

[Stim4me]

That's my confusion, why are codes missing. Haven't heard anything from AMA yet

 

[hyperalgesia]

From https://www.aapc.com/memberarea/forums/139017-2017-epidural-codes-image-guidance.html

62320 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without
imaging guidance

62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or
catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging
guidance (ie, fluoroscopy or CT)

62322 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without
imaging guidance

62323 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic,
opioid, steroid, other solution), not including neurolytic substances, including needle or
catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with
imaging guidance (ie, fluoroscopy or CT)

62324 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or
subarachnoid, cervical or thoracic; without imaging guidance

62325 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or
subarachnoid, cervical or thoracic; with imaging
guidance (ie, fluoroscopy or CT)

62326 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or
subarachnoid, lumbar or sacral (caudal); without
imaging guidance

62327 Injection(s), including indwelling catheter placement, continuous infusion or intermittent
bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid,
other solution), not including neurolytic substances, interlaminar epidural or
subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)

 

[DrCommonSense]

ASIPP just posted this. They show "increases" compared to "proposed" 2017 CMS payments. But If you compare 2016 to 2017 directly, essentially all in office payment is negative. Our own society trying to deceive us?? Sad

http://files.constantcontact.com/be15115b001/d4cffa3d-9ce3-47df-867b-5e69ed8e0ecb.pdf

I saw an alert where they claimed there was a decrease in hospital fees or ASC fees. Is this true? He claimed an increase in office payments.

 

[Disciple]

Yes, it looks like significant cuts for facility fees (ASCs and HOPDs). Surgery centers are really over and I anticipate the salaries of the hospital employed doctors to be slowly eroded.

Boutique it is. Ultrasound, and shared office space/procedure rooms.

 

[Ducttape]

Yes, it looks like significant cuts for facility fees (ASCs and HOPDs). Surgery centers are really over and I anticipate the salaries of the hospital employed doctors to be slowly eroded.

Boutique it is. Ultrasound, and shared office space/procedure rooms.

I see only the proposed schedule on ASIPP. Have you seen the final schedule?

The proposed cuts for ASC are around 16.7% for a lot like ESI and MBB, flat for RFA, Up for TF???


Sent from my iPhone using SDN mobile

 

[Disciple]

Yes, e-mail from ASIPP.

Basically, professional fees unchanged, facility fees for ASC/HOPD cut about 11% for bread & butter procedures (interlaminar, lumbar transforaminal, facets, lumbar sympathetic blocks). No facility fees for 77002. No additional facility fee for 2nd/3rd level or bilateral.

Increases for cervical transforaminal and Stellates (facility fee).

I didn't see any significant reductions for office procedural fees.

 

[Ducttape]

can you look again at Lumbar TF and LSB for ASC and HOPD? it appeared that those fees might have increased? at least based on the document Stim posted.

 

[Disciple]

can you look again at Lumbar TF and LSB for ASC and HOPD? it appeared that those fees might have increased? at least based on the document Stim posted.

You're correct. Increased in facility fees for lumbar TFs and LSB (both hospital and ASC)

One thing I noticed, since 2007, ASC facility fees for most bread and butter pain procedures have increased 4%. 60+% for hospitals.