AmBaseer
Guest
I work for a mobile xray and ultrasound provider and we use code R0070 to bill for transportation service. We are in the state of Illinois where Medicare follws the fee schedule set by NGS according to which R0070 is paid $116.23. We have been having an issue with Aetna as a Medicare Advantage payer that they pay only $3.99 for R0070 following the Medicaid fee schedule. The reason they give is that code R0070 is not found in the CMS fee schedule on CMS.gov. I checked with Medicare and they said it will not be on CMS.gov as it is determined by the local MAC, which in this case is NGS. Aetna will not follow the NGS fee schedule. What are our options in this case? Can we file a complaint with Medicare or is there a way to request that the code be updated on CMS.gov?