AGA: 8 CMS emergency updates to the 2016 Medicare Physician Fee Schedule to know

CMS released an emergency update to its 2016 Medicare Physician Fee Schedule, which addresses technical errors in the MPFS update files. The changes will be retroactive to Jan. 1, according to the American Gastroenterological Association.

 

The emergency update affected GI/endoscopy office payments. Here are the top eight codes with the highest reductions in non-facility payment.

CPT 45346 (Sigmoidoscopy with ablation)
•    New 2016 non-facility payment: $3,166.89

CPT 45388 (Colonoscopy with ablation)
•    New 2016 non-facility payment: $3,327.29

CPT 44401 (Colonoscopy with ablation)
•    New 2016 non-facility payment: $3,308.32

CPT 43220 (Esophagoscopy balloon less than 30 mm)
•    New 2016 non-facility payment: $1,151.11

CPT 43213 (Esophagoscopy retro balloon)
•    New 2016 non-facility payment: $1,244.20

CPT 91112 (GI wireless capsule)
•    New 2016 non-facility payment: $1,090.24

CPT 91112 with modifier TC (GI wireless capsule measure)
•    New 2016 non-facility payment: $978.53

CPT 43249 (Esoph EGD dilation less than 30 mm)
•    New 2016 non-facility payment: $1,090.60

Click here to learn more about the emergency update.

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