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Medicare facet & rfa payment logic

  1. Question Medicare facet & rfa payment logic
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    Does anyone know where I can find an explanation of Medicare's logic in payment amounts for 2010?

    The allowable amounts for 2 &3 level Facets & Paravertebral RFA's are already 1/2 of the primary level payment amount for 2010. When paying, medicare is 1/2 that amount as well. I'm trying to figure out (understand) why they would cut an amount in half that has already been halved. I understand multiple procedure discounting but, the base price is ALREADY been discounted.

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    Quote Originally Posted by melert View Post
    Does anyone know where I can find an explanation of Medicare's logic in payment amounts for 2010?

    The allowable amounts for 2 &3 level Facets & Paravertebral RFA's are already 1/2 of the primary level payment amount for 2010. When paying, medicare is 1/2 that amount as well. I'm trying to figure out (understand) why they would cut an amount in half that has already been halved. I understand multiple procedure discounting but, the base price is ALREADY been discounted.
    They are trying to get in line with OPPS, the payments for pain and GI will go down again next year due to this.
    Mary, CPC, CANPC, COSC

  3. Default
    Thanks for your reply. I thought, this being transition year 3, that payments were supposed to go UP from now on & only year's 1& 2 were the down years.

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