My memory is that ten or fifteen years ago, MACs never listed the prices of contractor-priced codes. I recall one client being told, "We here at (MAC) have set your price, but if you want to know what it is, you have to submit a claim and look at the reimbursement, or else, file a FOIA request to learn what we priced you at."
Now, in 2022, it seems common that MACs have websites that show carrier-based priced. This can have financial implications; for example, the main code used by the public comment iRhythm does not have a nationally set price, and investor analysts search around the MAC websites to find out the current price or if it has changed.
Here are some basic links.
- CGS Administrators, LLC
- Contractor Priced Codes Not Published
- First Coast Service Options, Inc.
- Contractor Priced Codes Published
- 2022 Medicare Part B Contractor-Priced Codes for Florida
- National Government Services, Inc.
- Contractor Priced Codes Not Published
- Noridian Healthcare Solutions, LLC
- Contractor Status Codes (C-Status)
CMS does not establish fees for C status codes; they are priced per Contractor discretion. Each year these code prices are reviewed and revised (price increase and/or decrease varies from code to code). Normally, prices are not determined until they are billed. Our review of medical records will assist in the evaluation and pricing of these services. Updates to contractor priced fees will be posted quarterly.
- Novitas Solutions, Inc.
- Contractor Priced Codes Not Published
- Local contractor pricing
Novitas will establish RVUs and payment amounts for these services, generally on an individual case basis following review of documentation. At this time Novitas does not have a published list of contractor priced codes.
- Palmetto GBA, LLC
- Contractor Priced Codes Not Published
- Wisconsin Physician Service Government Health Administrators
- Some Contractor Priced Codes Published
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.