The Centers for Medicare and Medicaid Services Issues Ruling on 2015 Reimbursement Rates

Posted by:  :  Category: Medicare

This News Release may contain forward-looking information that involves risks and uncertainties, including statements about Hologic’s 3D mammography technology. There can be no assurance this product will achieve the benefits described herein and that such benefits will be replicated in any particular manner with respect to an individual patient as the actual effect of the use of the product can only be determined on a case-by-case basis depending on the particular circumstances and patient in question. Hologic expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any such statements presented herein to reflect any change in expectations or any change in events, conditions or circumstances on which any such statements are based.
Source: hologic.com

Calculating Medicare Fee Schedule Rates

MPPR is a per-day policy that applies across disciplines and across settings. For example, if an SLP and a physical therapist both provide treatment to the same patient on the same day, the MPPR applies to all codes billed that day, regardless of discipline. Under MPPR, full payment is made for the therapy service or unit with the highest practice expense value (MPFS reimbursement rates are based on professional work, practice expense, and malpractice components) and payment reductions will apply for any other therapy performed on the same day. For the additional procedures provided on the same day, the practice expense (i.e., support personnel time, supplies, equipment, and indirect costs) of each fee will be reduced by 50% (effective April 1, 2013) for Part B services in all settings. The professional work and malpractice expense components of the payment will not be affected. ASHA has developed three MPPR scenarios to illustrate how reductions are calculated.
Source: asha.org

Medicare Coverage of Speech

This area of the Reimbursement site provides information on the major aspects of Medicare related to audiology and speech-language pathology services, including Medicare coverage guidelines and reimbursement rates.
Source: asha.org

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