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The Centers for Medicare and Medicaid Services (CMS) published in the Federal Register, August 23, 2006, proposed rates for services in hospital-based outpatient departments in 2007. The Medicare hospital Outpatient Prospective Payment System (OPPS) establishes payment rates for all services except speech-language pathology, physical therapy, and occupational therapy. Therapy services are paid under the Medicare Physician Fee Schedule (MPFS) for all Part B patients.
There are several diagnostic procedures used by speech-language pathologists, but not considered rehabilitation codes by CMS and thus are paid under OPPS. Below are the proposed rates for 2007 (with their corresponding CPT codes) as compared to the current 2006 rates.
Hospital vs. Non-Hospital Outpatient Rates
CPT |
Description
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OPPS 2007 Proposed |
OPPS 2006 |
MPFS* 2006 (non-hospital) |
| 31579 |
Laryngoscopy with strobe |
$238 |
$251 |
$236 |
| 74230 |
Fluoroscopy (for dysphagia) |
$89 |
$87 |
$80 |
| 70371 |
Fluoroscopy (for pharyngeal & speech evaluation) |
$80 |
$79 |
$128 |
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*Medicare Physician Fee Schedule
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For further information, please contact Mark Kander, ASHA's Director of Health Care Regulatory Analysis, via e-mail at mkander@asha.org or by phone at 800-498-2071, ext. 4139.
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