[DYSPHAGIA] [Fwd: CMS Releases 2002 Medicare Fee Schedule]

[harrisbm@musc.edu (bonnie harris)]

-------- Original Message --------
Subject: CMS Releases 2002 Medicare Fee Schedule
Resent-Date: Fri, 2 Nov 2001 18:00:46 -0500
Resent-From: asha-hdln@postman.com
Date: Fri, 02 Nov 2001 18:05:24 -0500
From: "Arlene Pietranton" <APietranton@asha.org>
To: asha-hdln@postman.com

CMS Releases 2002 Medicare Fee Schedule

On November 1, 2001, the Centers for Medicare and Medicaid Services
(CMS) published the 2002 Medicare Physician Fee Schedule (MPFS).  A copy
of the 2002 fee schedule can be found on the CMS web site at: 
www.hcfa.gov/medicare/pfsmain.htm.  The MPFS determines the payment
rates under Medicare Part B to outpatients including hospital and
skilled nursing facility inpatients that no longer have Part A status. 
In spite of a 5.4% decrease in the annual conversion factor from
$38.2581 to $36.1992 (unless Congress acts to alter the conversion
factor update), most speech-language pathology, dysphagia, and
vestibular function procedure rates are increased for 2002.  The rate
for each procedure is determined by multiplying the conversion factor by
the total relative value units for each procedure.

Some of the increases and diminished losses are attributable to ASHA's
practice expense surveys presented before committees of the American
Medical Association (AMA).  The dramatic percentage increases for all
vestibular function tests came after ASHA made a presentation to the AMA
Practice Expense Advisory Committee (PEAC).  These increases for the
technical component of the vestibular tests represent a full relative
value unit over the August 2001 proposed values.  

The reduction in the audiometric procedures is a consequence of their
placement in the zero work pool.  As reported last month, ASHA has
strongly urged CMS to establish a more equitable fee determination
methodology for diagnostic tests that do not have a physician
component.  There is an ongoing need to allow fees for audiometric tests
to increase through the incorporation of an officially recognized
increase in the audiologist wage rate.  All audiometric tests and many
other testing procedures currently share a single budget known as the
"zero physician work pool."  CMS has, for several years, discussed the
need to develop a substitute payment methodology.  Intensive advocacy
efforts are underway to address this problem through the relative update
process and with CMS.

The following is a brief summary of common procedures used by ASHA
members and value changes over the 2001 fee schedule that become
effective on January 1, 2002:

92506* 
Speech-language pathology evaluation	$94.84		+16%

92507  
Speech-language pathology treatment	  75.29		+20%

G0195  
Dysphagia clinical evaluation			127.42		+4%

G0196  
Dysphagia MBS study			127.42		+4%

G0197  
Speech gen. device evaluation              	126.70		+0.3%

G0198  
Speech gen. device training			  78.19		-1%

92541   
Spontaneous nystagmus test (global)	  68.42		+90%

92541  
Spontaneous nystag test (tech component)    45.97                  
+480%	 

92543
Caloric vestibular test (global)		  18.46		+61%

92543  
Caloric vestibular test (tech component)	  12.67		+276%

92557   
Comprehensive hearing test		  44.52		-10%

92567   
Tympanometry 			  19.91		-10.3%

92585	
ABR (global)  			  94.84		-19%

* CPT codes and descriptions are copyright 2001 American Medical
Association

In addition, as proposed in August 2001, CMS will no longer require that
services be rendered by a physician's employee in order for the
physician or physician group to bill Medicare for a professional's
services.  Audiologists and speech-language pathologists will still have
to negotiate payment rates with the physician or physician group
practice.  This change will improve access to audiology and
speech-language pathology services because it relieves the burden of
establishing an employer-employee relationship.

A comprehensive review of the 2002 fee schedule will be published in the
ASHA Leader.  A complete fee schedule each for audiology and
speech-language pathology services will be available on the ASHA website
and at the ASHA annual convention in New Orleans.  For more information,
please contact Mark Kander, ASHA's Director of Health Care Regulatory
Analysis by e-mail at mkander@asha.org, or at 800-498-2071, ext. 4139.
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