CMS Issues Corrected CY 2016 MPFS RVU File

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Melody MulaikBy Melody W. Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H

The 2016 Medicare Physician Fee Schedule Final Rule stated that the new LDCT screening code (G0297) would have the same RVUs as a non-contrast chest CT scan (71250). However, the initial 2016 RVU file showed much lower RVUs for G0297 than for 71250. CMS subsequently released an emergency update to the MPFS in Transmittal 3438/Change Request 9495, issued January 8, 2016.

According to the ACR’s “LDCT Lung Cancer Screening FAQs,” the new national average payments are now approximately $255 for the global service, $52 for the professional component, and $203 for the technical component. The ACR also states that G0297 is assigned to APC 5570 under the Outpatient Prospective Payment System with an average payment of $112.49.

You can access Transmittal 3438 here:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2016-Transmittals-Items/R3438CP.html?DLPage=1&DLEntries=10&DLSort=1&DLSortDir=ascending

The ACR FAQs document is available on their website at:

http://www.acr.org/~/media/ACR/Documents/PDF/Economics/ACR%20Updates%20LCS%20FAQ%20(2).pdf


Melody W. Mulaik, MSHS, CRA, FAHRA, RCC, CPC, CPC-H is the president of Coding Strategies, Inc. in Powder Springs, GA. She is a member of AHRA’s regulatory affairs committee. She can be reached at Melody.Mulaik@codingstrategies.com.

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