Medicare Physician Fee Schedule Database Update – July 2018

July brings changes to the 2018 Medicare Physician Fee Schedule Database (MPFSDB).  Changes are effective for dates of service beginning July 1, 2018.

PE RVU Imaging Code Changes

  • CPT Code 71045 (radiologic examination, chest, single view, frontal) and CPT Code 71046 (radiologic examination, chest, two views, frontal and lateral) have changes to the Facility and Non-Facility PE RVUs. 71045 will change to 0.42 and 71046 will change to 0.35.

Indicator Change for RHC and FQHC Care Management Codes

  • G0511 (Rural health clinic or federally qualified health center (RHC or FQHC) only, general care management, 20 minutes or more) and G0512 (Rural health clinic or federally qualified health center (RHC or FQHC) only, psychiatric collaborative care model (psychiatric COCM), 60 minutes or more) will have a PC/TC indicator of “0”.

Changes Effective for G0460 (Autologous platelet rich plasma for chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment)

  • Change status of A, Work RVU=2.25, non-facility PE RVU=2.89, Facility PE RVU=.94, Malpractice RVU=.34, Multiple Procedure=2, Bilateral Surgery=0, Assisted Surg=1, co-surgery=0, Team surgery=0 and Global Days=000

Indicator Change for New Q Codes

  • The following new injection codes for 2018 Q9991, Q9992, Q9993, and Q9995 are assigned procedure status E, excluded from physician fee schedule by regulation. These codes are for items and/or services that CMS chose to exclude from the fee schedule payment by regulation. No RVUs or payment amounts are shown and no payment may be made under the fee schedule for these codes. When covered, ayment for these codes continues under reasonable charge procedures effective July 1, 2018.

The following new CPT Category III codes were accepted by the CPT Editorial Panel September 2017 followed by a six-month implementation period and will become effective for dates of service beginning July 1, 2018:

0505T Endovenous femoral-popliteal arterial revascularization, with trans-catheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intra-procedural road mapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed, with crossing of the occlusive lesion in an extra luminal fashion
0506T Macular pigment optical density measurement by heterochromatic flicker photometry, unilateral or bilateral, with interpretation and report
0507T Near-infrared dual imaging (i.e., simultaneous reflective and trans- illuminated light) of meibomian glands, unilateral or bilateral, with interpretation and report
0508T Pulse-echo ultrasound bone density measurement resulting in indicator of axial bone mineral density, tibia

To learn addition information regarding the July 2018 changes, we recommend following the links below:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10644.pdf

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10624.pdf

https://www.aapc.com/blog/42469-july-2018-update-to-mpfs/