Some good news on the reimbursement front (finally!)

[Gfunk6]

From ASTRO

Final Rule: No OPPS cap; ASTRO helps avert major cuts

The Centers for Medicare and Medicaid Services (CMS) announced on November 23 that it is holding off on a major policy change to cap freestanding technical payment rates at the outpatient level, thereby agreeing with ASTRO's arguments and sparing freestanding centers from significant cuts. While the 2014 final Medicare Physician Fee Schedule (MPFS) estimates a positive 1 percent impact on radiation oncology—a major gain from cuts of 5 percent proposed for the specialty in July—ASTRO believes that freestanding centers still will experience payment reductions in 2014, primarily from changes to the Medicare price index and other policies impacting the practice expense component (equipment, non-physician labor and supplies) of the physician global payment. ASTRO is very concerned about yet another year of payment cuts facing freestanding members and continues to advocate with CMS and Congress for more stable and equitable payments for radiation oncology services. ASTRO has prepared detailed summaries of both the 2014 Medicare Physician Fee Schedule and Hospital Outpatient Regulations. Members are encouraged to participate in the ASTRO 2014 Final Rules Webinar hosted by David Beyer, MD, FASTRO, and Najeeb Mohideen, MD, on December 11 at 3:00 p.m. Eastern time to learn more about the changes and new CPT codes.

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[medgator]

Especially good news on the freestanding side

 

[thesauce]

How freakin' awesome is that?

 

[medgator]

How freakin' awesome is that?

very awesome when you consider what happened to everyone else this year. My med onc colleague was griping about cut while we "got an increase"

Fyi

Specialty Proposed Rule Final Rule
Hematology/ Oncology -1% -2%
Radiation Oncology -5% 1%
Radiation Centers -13% -1%
Radiology -1% -2%
Gastroenterology 1% -2%
Rheumatology -1% -4%
Urology -2% -1%
Independent Lab -26% -5%

 

[medgator]

Anyone have any info on why all outpatient visits for hospital based practices will be billed the same level (bye bye levels 1-5) and is this happening for free standing centers?

according to the ASTRO link from the OP, it appears to only be affecting hospital outpatient codes:

Hospital Outpatient Visits
For CY 2014, CMS will replace the five levels of outpatient clinic visit codes with a single Healthcare Common Procedure Coding System (HCPCS) code describing all clinic visits. CMS believes a single code and payment for clinic visits is easier administratively for hospitals and better reflects hospital resources involved in supporting an outpatient visit. In the final rule CMS states that the current five levels of outpatient visit codes are designed to distinguish differences in physician work.

In CY 2014 all clinic visits will be reported with G0463 (Hospital outpatient clinic visit) with a payment rate of $92.53. In CY 2013 rates for clinic visits went from $73.68 to $175.79.