CMS Maintains Contractor Pricing for PET Codes
CMS was persuaded by ASNC and its sister societies and has proposed to maintain contractor pricing for the technical component of Myocardial PET services (CPT codes 78432, 78459, 78491, and 78492) for 2021. Additionally, in response to new information provided to CMS by ASNC, the American College of Cardiology and the Society of Nuclear Medical and Molecular Imaging, CMS is proposing to update the price for the nuclide rod source set (ER044) equipment from $1977.2497 to $2,081.17.
CMS is also proposing to:
- add the ER044 equipment to CPT codes 78432, 78459, 78491, and 78492 as requested, assigning the same equipment time utilized by the “PET Refurbished Imaging Cardiac Configuration” (ER110) equipment in each service;
- update the useful life of the ER044 equipment to one year instead of 5 years as previously finalized; and
- remove the “PET Generator (Rubidium)” (ER114) equipment from its database.