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Reimbursement Policy Update for June 30, 2023

Reimbursement PolicyRevision

Multiple Procedure Payment Reduction (PDF)

Updated coding section with instruction to reference CMS Physician Fee Schedule and removed coding grid.  No change to policy intent.
Radiology Services (PDF)Updated coding section with instruction to reference CMS Physician Fee Schedule and removed coding grid.  No change to policy intent.
Services Bundled Inpatient Outpatient (PDF)

Added verbiage to Reimbursement guidelines section to clarify inpatient reimbursement being considered all-inclusive. Clarified Rationale section. MD Approved.

Clarification added to Routine Surgical grid “Skin closure devices” and “Surgical Clips and Staplers“.  Clarification added to Routine Respiratory “PEP instruction and/or therapy”.  No change to policy intent.