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by Nancy Swigert
ASHA’s Health Care Economics Committee met with several officials of the Centers for Medicare and Medicaid Services (CMS) this spring to discuss a variety of coding and reimbursement issues. Some of these issues included the requirement for outpatients to visit their physician every 30 days, cochlear implant coverage as a diagnostic service, nonphysician work pool, and group therapy services. The CMS officials agreed to look at the low rate assigned on the 2003 Medicare Fee Schedule for clinical dysphagia evaluation and modified barium swallow. Their analysis revealed that the reason the rates dropped was as suspected: that the codes have no physician work included. The committee continues to explore avenues to revalue the codes.
The committee also is working closely with the American Psychological Association to gather data on 96105, assessment of aphasia, to present to the AMA RUC HCPAC. They will attempt to get physician work included in that code, as psychologists are recognized as independent providers by Medicare. The committee is working with related groups to develop a code for tinnitus assessment and is in the process of determining how explicit the code should be. The committee welcomes input from members on any coding and reimbursement issues. Contact Steven White at swhite@asha.org .
Nancy Swigert is president of Swigert & Associates, Inc., in Lexington, KY.
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