This website uses cookies to store information on your computer. Some of these cookies are used for visitor analysis, others are essential to making our site function properly and improve the user experience. By using this site, you consent to the placement of these cookies. Click Accept to consent and dismiss this message or Deny to leave this website. Read our Privacy Statement for more.
Careers | Join | About | Print Page | Report Abuse | Sign In
SCCT urges members to take action on CMS proposed cuts
Share |

 

 

 

 

Update on Medicare 2020 Payment– and next steps for SCCT

On November 1, CMS released the final payment rule for the 2020 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS). The payment rates for our codes (75572, 75573 and 75574) will be $182.20, a decrease of about $19.54.

Despite strong and unprecedented efforts from SCCT, ACC and ACR, and over 100 members submitting comments, CMS opted to maintain the rates in their initial proposed rule, stating that the claims data for cardiac CT codes show that the geometric mean cost is between $159 and $196. 

As a result, CMS decided to maintain the current APC placement for CPT codes 75572, 75573, and 75574. CMS responded to comments suggesting these codes be moved to 5573 or 5593, saying: “We believe it would be inappropriate to reassign the codes to these suggested APCs because their geometric mean costs are significantly higher.” 

 

View a snapshot of the PC/TC reimbursement amounts for CCTA codes

 

Learn more about 2020 Medicare OPPS Final Rule  

 

 Next steps to increase payments for cardiac CT

Although SCCT leaders are disappointed with this outcome, we are doubling down on our efforts to improve payment for cardiac CT, and are invigorated by the enormous support from our members and partners. We are launching the following efforts:

  • Grassroots initiative to improve billing data from facilities across the country, as this data is used by CMS to estimate procedural cost
  • Maintain ongoing dialogue with CMS officials to identify better methods for determining the actual cost of CCTA services
  • Continued strong collaboration with ACC and ACR
  • Outreach to Congressional leaders to establish and foster relationships for future advocacy efforts

 

What is your center charging CMS for cardiac CT services?

To learn what your center is charging CMS, or to ask other questions, please contact Dawn Brennaman at dbrennaman@scct.org.