March 2007 | Vol. 25, No. 3

Clarification on DRA Reimbursement Cuts of 01/01/07

There seems to be some confusion among SVU members as to the actual 2007 vascular ultrasound fees as a result of the DRA reimbursement cuts that when into effect on Jan. 1, 2007. Carriers will continue to publish the Physician Fee Schedule (“PFS”) that Part B providers are used to referring to find their reimbursement rates for vascular exams. In addition, however, they will publish a table entitled “Payment Cap for the Technical Component of Imaging Procedures for Disclosure” or similar file. This is the first schedule you should check and if the vascular code in question is not listed here, then refer to the PFS. You also should consider directly contacting your Medicare carrier by phone or by email or check their website to be sure that you are using the 2007 fee schedule that includes the DRA reimbursement cuts approved by Congress. Some fee schedules that were released in late 2006 did not include the final fee schedule with the DRA cuts included and are being incorrectly used in 2007 by vascular labs to submit their claims. Make sure you are using the version of the 2007 physician fee schedule that includes the DRA reimbursement cuts.