CMS (OPPS) Reimbursement Education Program
“We have privileges to perform focused ultrasound at that Hospital, but since Medicare dropped the reimbursement rates, they can no longer afford to schedule any more procedures there.” —Dr. Stanley A Myers, MD, Northwest Urology in Portland, Oregon
An overarching goal of the Focused Ultrasound Foundation is for focused ultrasound-based procedures to become the standard of care for all applicable indications. For this to happen, institutions that are treating with focused ultrasound need to be reimbursed appropriately for the work they are performing. Unfortunately, the path from billing to actual reimbursement is not a straight or simple one, especially for a technology that is relatively new to the commercial patient treatment space.
To help healthcare facilities navigate the complexities of Centers for Medicare and Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) billing for focused ultrasound-based procedures, the Foundation is sponsoring educational seminars that will assist finance and revenue cycle teams in generating a chargemaster that is best suited to their unique circumstances. This program, conducted by leading healthcare economics consulting firms, generally consists of a one-hour meeting between the finance groups from individual institutions and a subject matter expert from one of the firms. These meetings are interactive in nature and in-person discussions are preferred, although video conferencing can easily be arranged.
To get a feel for the concepts that are covered in these meetings, please watch this brief presentation from one of our consultants.
Below is a list of the indications that are currently being reimbursed in the US, along with a link to the consulting firm that conducts the education program for that indication.
Essential Tremor – Dobson DaVanzo & Associates, LLC.
Bone Metastases – Coming soon
Prostate Cancer – Coming soon
If you are part of the finance and revenue cycle team at a healthcare facility that has a chargemaster for focused ultrasound-based procedures and would like to participate in one of these educational seminars or would like to learn more about them, please contact Michael Broad (firstname.lastname@example.org | +1 434.277.1430) for an introduction to the relevant subject matter expert.