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Dr. Rubenstein on changes in reimbursement for iTind, HIFU


“HIFU also has gone up in its APC, so there's a higher reimbursement for the facility fees for hospital or ASC setting,” says Jonathan Rubenstein, MD.

In this video, Jonathan Rubenstein, MD, discusses coding changes involving the iTind procedure and high-intensity focused ultrasound. Rubenstein is compliance officer and medical director of coding and reimbursement, United Urology Group and Chesapeake Urology, in Towson, Maryland.


Another change of note involves the iTind procedure. The Ambulatory Payment Classification (APC), which is the overall practice expense valuation for Medicare, had gone up. Before, nationally, it was in the $2500 range. And now, nationally, it's in the $7000 range for ASCs [ambulatory surgical centers] and a little bit higher for hospitals. So it's important to know because there's a C code that can help reimburse for practice expense. So that has been a change for this year. Similarly, HIFU [high-intensity focused ultrasound] also has gone up in its APC, so there's a higher reimbursement for the facility fees for hospital or ASC setting. HIFU has a category I CPT [Current Procedural Terminology] code that should be reported and then the APC is associated with that code, whereas iTind does not currently have either a category I nor category III CPT code associated with it.

This transcript was edited for clarity.

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