Medicare says reimbursement for in-office drug administration will increase, but impact on urology is unclear
The Centers for Medicare & Medicaid Services said it has made "significant" changes in Medicare's approach to paying for drugs administered in the physician's office that will allow increased coverage in 2005 for both the drugs and their administration.
The Centers for Medicare & Medicaid Services said it has made "significant" changes in Medicare's approach to paying for drugs administered in the physician's office that will allow increased coverage in 2005 for both the drugs and their administration. However, the reimbursement rates for a number of drugs commonly used to treat prostate and bladder cancer appear to be dropping significantly.
According to a CMS press release discussing the final rule for physician payment for 2005, the higher payments are based on data from the American Society for Clinical Oncology and include payment for staff time to prepare pharmaceuticals and physician work for supervising of their preparation. Information about reimbursement for specific urology drugs was not available as this issue of Urology Times E-news was being prepared.
The final rule will be published in Nov. 15, 2004 Federal Register. Look for details on the new fee schedule's impact on urologists in the December issue of Urology Times.
Potential code for prior authorizations on AMA CPT Editorial Panel meeting agenda
March 28th 2024"Good public and economic policy must align costs, benefits, and incentives; currently, all costs are incurred by physician practices, and all financial savings and benefits from prior authorization accrue to health insurance plans, leading to perverse incentives,” says Alex Shteynshlyuger, MD.
