CMS’ Proposed Physician Fee Schedule for CY 2012 Revises Bone Density Service Codes

In recent years, the Centers for Medicare & Medicaid Services (“CMS”) has taken steps to address potentially undervalued and overvalued services under the Medicare Physician Fee Schedule. In the recently released Proposed Physician Fee Schedule for calendar year (“CY”) 2012, CMS specifically addresses payment codes for bone density tests. Since the payment calculation specified by Section 1848(b)(6) of the Social Security Act no longer applies for CY 2012, CMS proposes changes to the payment rate for Current Procedural Terminology (“CPT”) codes 77080 and 77082 (the dual energy x-ray absorptiometry codes). The payment rate “will be based upon resource-based, rather than imputed, RVUs, and the current year’s conversion factor.” CMS further requests that the American Medical Association/Specialty Society Relative Value Scale Update Committee (“RUC”) review these codes during CY 2012.

For professional assistance navigating the ever-evolving healthcare landscape or more information regarding the Proposed Physician Fee Schedule for CY 2012, please contact Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. at (248) 996-8510 or (212) 734-0128, or visit the HLP website.