Wiki NJ 2013 pip fee sched help?

[jennburgel]

I work for an ASC. Has anyone been paid in NJ according to the new pip fee schedule ror 2013? We are having a hard time deciphering the primary vs secondary procedures. Fee sched reads for example 64490 =$ 931.80 which is the primary code 64491= $ 327.00 for the secondary. They are paying 1/2 for the secondary procudre ie: 163.50. Why do they give a fee for 64491 and 64492 when they are add on codes and cannot be billed without 64490. Help !!! We just want to know how to expect to be paid so we can bill accordingly.

 

[TWIEGANDT]

The 2013 NJ PIP regulations indicate that any additional levels will be reduced by 50%. Therefore, when billing a 3 level facet, you would be reimbursed 100% for the 1st level, $931.80, then 50% (from the CPT code) for each additional level ($163.83 x2) for a total of $1,259.46).