DXA Payments Increase. ACR Advocacy Is a Success!
May 13, 2010
The Centers for Medicare and Medicaid Services released the changes for increased DXA reimbursement earlier this week. The increase came from a provision of the Patient Protection and Affordable Care Act. The ACR lobbied on this issue for several years with other societies and our voices were heard! (DXA story, DXA legislative priority summary)
CMS is advising Medicare carriers to increase reimbursement for DXAs starting on June 1, 2010. Procedures that were performed before May 31, 2010 in 2010 will be retroactively paid at the higher rates, but CMS is still figuring out how best to handle those claims. The DXA increase is 70 percent of the relative value for the services in 2006 (and the 2006 conversion factor). The increase will be in effect for 2010 and 2011 while a study is being done on the ramifications of payment reductions.
The ACR is aware that the RVU for 77082 has decreased and is currently investigating the reason for this decrease.
Payment Corrections
Below are the adjusted RVUs for these services:
CPT |
WRVU |
NON-FACILITY |
NON-FACILITY |
MALPRACTICE |
|---|---|---|---|---|
77080 |
|
|
|
|
0.20 |
1.02 |
1.48 |
0.02 |
|
0.22 |
2.35 |
|
0.13 |
|
77082 |
|
|
|
|
0.17 |
0.50 |
0.57 |
0.02 |
|
0.12 |
0.59 |
|
0.05 |
Example of Reimbursements of Payments
An example of the reimbursements of payments from 2006, January 1 – May 31, 2010 and June 1 – December 31, 2010 using Atlanta, Georgia GPCI is listed below:
2006 |
Non-Facility Fee |
Non-Facility Fee |
Non-Facility Fee |
||
|---|---|---|---|---|---|
76075 |
$143.32 |
77080 |
$45.21 |
77080 |
$97.92 |
$15.25 |
77080-26 |
$10.51 |
77080-26 |
$10.87 |
|
76077 |
$38.01 |
77082 |
$25.99 |
77082 |
$27.47 |
$8.92 |
77082-26 |
$8.69 |
77082-26 |
$6.13 |
This information was provided in a CMS Transmittal to Contractors on May 10, 2010. If you have any further questions, you may contact Melesia Tillman, CPC at
