Medicare Compliance & Reimbursement

Tech components get RVU increase.

Most labs were adversely affected by 2005's almost 50 percent pay cut for flow cytometry services.
 
"Not all flow cytometry was created equal," says Raul Braylan, professor of pathology at the University of Florida. Some types are easy to administer, but others require intense labor. The more complex types of services became tough to access after labs saw a roughly $200 payment reduction, he charges.

Providers, Take Heart: Help's Coming

Relief appears to be on the way. In the recently proposed physician fee schedule for 2006, the Centers for Medicare and Medicaid Services plans to increase the relative value units for flow cytometry's technical component from 1.34 to 1.64 for 88184 (Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker) and from 0.66 to 0.88 for 88185 (...each additional marker).

For 88184, payment will increase from an average $50.78 to $62.15 and for 88185, reimbursement would rise from an average $25.01 to $33.35.
 
Final Say On Matter Falls To Washington

However, increased payments hinge on legislators' approval of a fee update at least equal to that of 2005, or 1.5 percent. "The problem is that the SGR calls for a 4.3 percent reduction in pay rates per service," explains Annette Grady, CPC, CPC-H, a healthcare consultant with Eide Bailly in Bismarck, ND.

The good news is Congress overruled similar fee cuts in 2004 and 2005. And several bills are circulating Congress, including House Ways and Means Committee health committee chairperson Rep. Nancy Johnson's (R-CT) proposal that would increase payments by 1.5 percent in 2006 and eliminate the SGR.