Anesthesia & Pain Management Compliance Auditors

ACE Alerts

Keeping You Up-To-Date on the News You Need to Know
3
Aug

Proposed CMS Fee Schedule Released

The proposed physician fee schedule was released last week and in addition to the proposed unit value of $22.0353 (a slight reduction), there are going to be some major changes to anesthesia for endoscopy procedures if this goes forward.  Five new codes are proposed for 2018.  I created a table below to assist practices in measuring the impact to your practice.
New Code
Proposed Base Units
Current Code
Current Base Units
Impact to Practice
007X1-Routine EGDs
5
00740
5
No impact
007X2-ERCPs
6
00740
5
Additional 1 Unit
008X1-Colonoscopy- Non-screening
4
00810
5
Loss of 1 Unit
008X2- Colonoscopy- Screening
3
00810
5
Loss of 2 Units
008X3 – Combine EGD w/ Colonoscopy
5
Either 00740 or 00810
5
No impact

 

This will have a significant impact on revenue, twenty to thirty percent depending on the intent of the colonoscopy and only offset by the one unit increase on ERCP procedures.  Practices should review their volume of services and the related diagnosis to evaluate the financial impact.  You should also be aware that if the ASA does adopt this methodology, it will apply to all payors, not just Medicare.

Sincerely,
Devona
devonas@aceauditors.com