ACloserLook Reimbursement Issues in Diagnostic Imaging

Hospital Outpatient Prospective Payment System (HOPPS) Changes for 2006

The Centers for Medicare & Medicaid Services (CMS) published the HOPPS 2006 Final Rule in the Federal Register on November 10, 2005. These changes are effective January 1, 2006. On average, CMS has provided for an increase of approximately 2.2% from the 2005 payment levels.

Effective January 1, 2006, CMS will pay for most drugs (including contrast agents) based on average sales price plus six percent (ASP + 6%) as a proxy for average acquisition cost. This results in separate and additional payment for LOCM, HOCM, and MR contrast agents as compared with 2005. Additionally, CMS has discontinued the use of “A” codes and “C” codes for contrast media and implemented the use of “Q” codes for LOCM, HOCM, MR, and echo contrast agents.

Listed below are the “Q” codes and payment rates for these contrast agents:

HCPCS Description 2006 Payment (adjusted quarterly)
Q9945 LOCM, up to 149 MG/ML IODINE, per ML $0.29
Q9946 LOCM, 150 - 199 MG/ML IODINE, per ML $1.83
Q9947 LOCM, 200 - 249 MG/ML IODINE, per ML $1.24
Q9948 LOCM, 250 - 299 MG/ML IODINE, per ML $0.32
Q9949 LOCM, 300 - 349 MG/ML IODINE, per ML $0.36
Q9950 LOCM, 350 - 399 MG/ML IODINE, per ML $0.23
Q9951 LOCM 400 or greater MG IODINE, per ML $0.30
Q9952 INJ, GADOLINIUM-BASED MR, per ML $2.89
Q9953 IRON-BASED MR CONTRAST, per ML $30.41
Q9954 ORAL MR, PER 100 ML $8.98
Q9955 Inj, Perflexane, per ML $7.05
Q9956 Inj. Octafluoropropane, per ML $40.42
Q9957 Inj. Perflutren lipid microsphere, per ML $61.89
Q9958 HOCM, up to 149 MG/ML IODINE, per ML $0.06
Q9959 HOCM, 150 - 199 MG/ML IODINE, per ML --
Q9960 HOCM, 200 - 249 MG/ML IODINE, per ML $0.09
Q9961 HOCM, 250 - 299 MG/ML IODINE, per ML $0.16
Q9962 HOCM, 300 - 349 MG/ML IODINE, per ML $0.14
Q9963 HOCM, 350 - 399 MG/ML IODINE, per ML $0.39
Q9964 HOCM 400 or greater MG IODINE, per ML $0.19

For more information regarding the final HOPPS regulation for 2006, please access the CMS Web site at:
http://new.cms.hhs.gov/HospitalOutpatientPPS

Payment for Radiopharmaceuticals in the HOPPS Setting

For 2006, CMS has adopted a temporary one-year policy to pay all radiopharmaceuticals that are separately payable based on the hospital’s charge for each radiopharmaceutical reduced to cost by using the hospital’s overall cost-to-charge ratio. Hospitals will receive a newly calculated payment for each claim submitted for a separately payable radiopharmaceutical. In addition, many of the radiopharmaceutical code descriptors are different for 2006. CMS is expected to change the policy for 2007.

For more information regarding the final HOPPS regulation for 2006, please access the CMS Web site at:
http://new.cms.hhs.gov/HospitalOutpatientPPS

Winter 2006


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