The Center for Medicare & Medicaid Services (CMS) has released a technical correction to the 2010 Physician Fee Schedule that will increase reimbursement for myocardial perfusion imaging (MPI)--both planar and SPECT--cardiac CTs and cardiac catheterizations. All corrections are retroactive to January 1, 2010.
The changes made to MPI and cardiac CT codes address errors made in determining practice expenses associated with offering these services. Codes affected include: CPT codes 75571-75574 and 78451-78454. Increases in reimbursement ranged from a 16 percent increase for SPECT MPI with multiple studies (CPT code 78452-G) to a 161 percent increase for Planar MPI, multiple (CPT code 78454-TC). The new payments for the procedures mentioed are $439.65 and $318.47, respectively. A more detailed summary of the nuclear cardiology payment changes is provided by the American Society of Nuclear Cardiology.
CMS has also made changes to malpractice RVUs for cardiac catheterizations to reflect the higher risk associated with invasive procedures. Increases in the professional component for cardiac catheterizations range from 6 to 8 percent. For example, reimbursement associated with the professional component of a left heart catheterization (CPT codes 93510-26) has increased from $235 to $253. For more details on how reimbursement for cardiac catheterizations will be affected, please see the ACC's crosswalk.
While this is an important victory for the ACC, the American Society of Nuclear Cardiology and other advocacy groups, Jack Lewin, the CEO of the ACC, makes it very clear that this correction alone is not enough to address the dramatic cuts in reimbursement cardiologists have experienced. As such, ACC is going to continue to pressure CMS to phase-in bundled nuclear codes and increase reimbursement echos and other services through increased adherence to appropriate use criteria.
For more information on CMS's correction, please click on the following links: www.acc.org and www.acsn.org.