CMS to Publish 2003 Medicare Fee Schedule, Codes

As The ASHA Leader went to press, the Centers for Medicare and Medicaid Services (CMS) delayed the publication of the 2003 Medicare Physician Fee Schedule, originally scheduled to be released Nov. 1. The document, which will set Medicare reimbursement rates for all Part B services, is expected to introduce 17 new codes for procedures of interest to audiologists and speech-language pathologists.

ASHA’s Health Care Economics Committee (HCEC) developed these procedures and received approval for them from the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel. The HCEC also developed data for practice expense values and presented them to the Health Care Professionals Advisory Committee within the AMA relative value process (see " Crafting Reimbursement Codes ," The ASHA Leader , Oct. 8).

At press time, the exact reimbursement rates were not available for any Medicare procedure. However, CMS has indicated that overall Medicare payments will be reduced by at least 4.4% because of the Medicare and Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 mandates. For a list of all audiology and speech-language pathology codes and their values, visit ASHA's Web site .

Pending publication in The Federal Register , the new audiology and speech-language pathology CPT codes (CPT codes are copyrighted by the AMA 2002) for 2003 are expected to include the following:

Cochlear Implants

• 92601 —Diagnostic analysis of cochlear implant, patient under 7 years of age; with programming
• 92602 —Subsequent reprogramming
• 92603 —Diagnostic analysis of cochlear implant, age 7 years of age or older; with programming
• 92604 —Subsequent reprogramming

Augmentative and Alternative Communication (AAC)

• 92605 —Evaluation for prescription of non-speech-generating AAC device
• 92606 —Therapeutic service(s) for the use of non-speech-generating device, including programming and modification
• 92607 —Evaluation for prescription for speech-generating AAC device; face-to-face with the patient: first hour
• 92608 —Each additional 30 minutes (List separately in addition to code for primary procedure)
• 92609 —Therapeutic services for the use of speech-generating device, including programming and modification

Dysphagia Assessment

• 92610 —Evaluation of oral and pharyngeal swallowing function (clinical or bedside evaluation)
• 92611 —Motion fluoroscopic evaluation of swallowing function by cine or video recording
• 92612 —Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording
• 92613 —Physician interpretation and report only
• 92614 —Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording
• 92615 —Physician interpretation and report only
• 92616 —Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording
• 92617 —Physician interpretation and report only

ASHA anticipates that the temporary G-codes for speech-generating device services and dysphagia assessment will be deleted for 2003. And the 2003 CPT will retain 92510, which currently describes cochlear implant rehabilitation and programming.

For information on obtaining the complete CPT 2003 manual, visit www.ama-assn.org/ama/pub/category/3113.html .

These codes and the new values will be effective Jan. 1, 2003. For more information, contact Steven White by e-mail at swhite@asha.org  or through the Action Center at 800-498-2071, ext. 4126; or Mark Kander by e-mail at mkander@asha.org  or at ext. 4139.