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The proposal is now a reality. In July of this year, CMS’s 2018 Proposed Physician Fee Schedule outlined a change for screening colonoscopies that have now become reality. The final rule will have a big impact on practices that receive a portion of their revenue from colonoscopy services. Specifically, the impacted codes are as follows:

2018 Final Rule Anesthesia GI Reimbursement

From the CPT 2018 Professional codebook: “…this final rule addresses the valuation of services for purposes of Medicare payments made under the PFS. Valuation and payment determinations made by private insurers are outside the scope of this final rule.” Although this could lead private insurers to make valuation adjustments in the future that parallel the CMS rule.

abeo stands behind our clients as we are evaluating each client based on their unique case mix and volume to determine the financial impact this change will have on their anesthesia GI reimbursement. abeo clients are encouraged to discuss these changes and the impact this will have on endoscopic anesthesia documentation requirements and reimbursement with their Client Relationship Manager (CRM).

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abeo Management Corporation (abeo) serves as a leading source of revenue cycle management and practice management with a specialization in anesthesia. The company leverages its people, processes, and software to serve independent practices, surgery centers, hospitals and healthcare systems with a scope of services that include billing, coding, transcription, practice management, and business consulting.

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