Tuesday, August 10, 2010

Medicare payment for Echocardiogram CPT 93306 - 93307 93325 -

Medicare changed CPT Code for Echocardiogram and cut reimbursement by 15%


Medicare now has a combined CPT Code for Echocardiograms 93306 to replace the combined codes of 93307, 93320 & 93325. The 93306 reimbursement is 15% less than the combined three codes:
e.g. Michigan Region 1:  

Old reimbursement 
93307 = $192.16;
93320 = $85.40;
93325 = $63.13.
Total: $340.69

New reimbursement: 
93306 = $289.69.
This is a cut of $51.00.
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download