CMS Releases 2009 MPFSDB Update

The Centers for Medicare & Medicaid Services (CMS) recently notified contractors that it amended payment files based on the 2009 Medicare Physician Fee Schedule (MPFS) final rule. Transmittal 1691, Change Request (CR) 6397, issued March 4, instructs contractors to update their payment files in the Medicare Physician Fee Schedule Database (MPFSDB). Several important changes affecting all providers were made.

Changes in the April 2009 update to the MPFSDB include work relative value unit (RVU) adjustments for several CPT® and HCPCS Level II codes and procedure status changes for many CPT® and HCPCS Level II codes—including CPT® 0085T Breath test for heart transplant rejection, which was recently rendered a noncovered service in a National Coverage Determination (NCD).

The long descriptors for CPT® codes 93351, G0248, G0249, and G0250 have also changed.

CMS clarifies in the transmittal that newly created CPT® code 95992 Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), per day is a bundled code that physicians should bill as part of an evaluation and management (E/M) service. Therapists, who cannot bill for E/M services, should continue reporting this service with CPT® 97112 Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities.

The initial Recurring Update Notification (RUN) can be found in Pub. 100-04, chapter 23, section 30.1 of the Internet Only Manual. MLN Matters article MM6397 provides further clarification of these changes.

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