Reimbursement & Coding Procedures
Reimbursement
Navigating the reimbursement process can be a challenging task for all physicians. Nuclear cardiology faces unique payment and practice management issues in both the public and private sectors. View the topics below to find summaries of important developments in nuclear cardiology reimbursement.
- 2022 (and Prior) MPFS and HOPPS Payment Charts - Member only access
- PET Model Coverage Policy
- SPECT Model Coverage Policy
- ASNC MiBG Letter
CMS Releases 2022 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System Final Rules
(Nov. 7, 2021) - On Tuesday, Nov. 2, the Centers for Medicare & Medicaid Services (CMS) released the 2022 Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (HOPPS) final rules. Following ASNC's preliminary analysis of both rules, we want to make you aware of key policies and their potential implications. Read the full blog post.
ASNC, Partner Groups Submit Comments on Cardiac PET Reimbursement to CMS
On February 10th, ASNC, SNMMI, and ACC submitted a joint letter to CMS as part of an ongoing effort to ensure fair and accurate payment for PET services. The groups’ comments focus on providing additional information to correct direct practice expense inputs and how societies may be able to provide more comprehensive information on indirect costs for practice expense. The associations recommended the status quo of contractor pricing until recommendations from a CMS-convened technical expert panel can be analyzed or until acceptable information can be provided. Read the full letter.
Coding Information
Coding Tips
Given the numerous changes to billing and coding procedures for nuclear cardiology implemented annually, ASNC offers a series of articles to help practitioners who work with Medicare and private carriers secure appropriate reimbursement for nuclear cardiology services.
Basic Coding Guidance for Billing MPI SPECT - Part 1
Released June 2010
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