Government Relations
GR News
June 16, 2010
CMS to Correct Medicare Physician Fee Schedule (MPFS) PET Imaging Errors in Paid Rates
Beginning on May 24th, 2010, a number of members reached out to the SNM regarding a sudden spike in Medicare technical and global payments for PET studies, specifically for CPT codes 78811-78816, 78608, 78459, 78491, 78492 paid in the physician fee schedule. On June 3, 2010, CMS officials confirmed with the SNM that the recent update files submitted to Medicare administrative contractors and carriers, was incorrect and that a corrected file will be sent to the payers for the July 6th, 2010 MPFS update. During this discussion, the agency indicated that overpayments for claims already paid will be addressed on an individual contractor basis.
The SNM recommends that you contact your Medicare contractor for instructions regarding these overpayments. Click here for one example notice recently posted on the CAHABA website.
