Lithotripsy Payment Cut 21 Percent

Physicians will be paid considerably less for lithotripsy procedures performed on Medicare patients this year than was first thought, according to the Ambulatory Surgery Center Association (ASCA).

The national membership association reported on their website May 3 that the November 2011 payment rate for CPT® code 50590 Fragmenting of kidney stones was incorrect. Upon detecting the error, the Centers for Medicare & Medicaid Services (CMS) corrected the payment rate, resulting in a nearly 21 percent payment reduction for the procedure.

The November 2011 payment rate for 50590 was set at a national average of $2,102.29. The adjusted national average, effective Jan. 1, 2012, is $1,665.59, a reduction of $436.70.

According to ASCA, Medicare contractors are not supposed to automatically reprocess claims that have been paid at the incorrect amount.

Source: ASCA, Latest News, May 2012, “Medicare Reduces Lithotripsy Payment Rate


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