Does anyone have Medicare facility fee data, non-pro fees?

[pastafan]

I have spoken with my representative about the cost to the government of facility based procedures vs. office based. I pointed out how it is unfair and wasteful of taxpayer dollars to pay more for the same service based on the site of service. He asked me to get documentation for him. I know the Medicare pro fees but I don't know where to find the facility reimbursement for procedures and what the facility is paid when they bill for the non-pro portion of anesthesia services fees on top of the procedure.

I had been told that if an E&M is performed that they pay a huge amount to the facility that greatly exceeds what we get for office based professional fee. Does anyone have the data for ESI's and other common procedures?

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[emd123]

Is this what you're looking for?

Hospital (2013; Still waiting on ASIPP confirmation of final 2014 numbers)

http://www.asipp.org/documents/HOPD2013Final.pdf

ASC

http://www.asipp.org/documents/ASC2013Final.pdf

Physician professional

http://www.asipp.org/documents/Physcians2013Final.pdf

 

[pastafan]

Is this what you're looking for?

Hospital (2013; Still waiting on ASIPP confirmation of final 2014 numbers)

http://www.asipp.org/documents/HOPD2013Final.pdf

ASC

http://www.asipp.org/documents/ASC2013Final.pdf

Physician professional

http://www.asipp.org/documents/Physcians2013Final.pdf

Yes, Sir. That is exactly what I need. Any idea how they code or get paid for anesthesia services? I know that they have levels of charges for the OR but I don't know how they are coded for CMS.

 

[powermd]

Someone explain to me why IDET is listed with a fee even though it is not covered.

 

[Pacman27]

Yes, Sir. That is exactly what I need. Any idea how they code or get paid for anesthesia services? I know that they have levels of charges for the OR but I don't know how they are coded for CMS.

Don't use the ASIPP data. What state are you in. You can go to medicare webpage and look up the fee schedule specific to your area. What state are you in?

I have been battling with insurances companies regarding this same argument

Does an ESI or Facet Inj really need to be done in an ASC or HOPD setting