CMS released its final rule for 2019 allowed amounts for interventional vein procedures.
Generally, there is a decrease of up to 6% for key high dollar procedures for the first vein, while subsequent veins received a small increase in allowed amounts. The primary reason for the reductions is due to CMS’s re-evaluation of the practice expense component of the fee schedule formula. CMS hired a third-party consulting firm, StrategyGen, to do a market analysis of the direct expenses related to procedures and they concluded that direct expenses for interventional vein procedures have declined since last evaluated. It appears likely that CMS will phase in further reduction to these cases over 4 years, through 2022.
Key Vein Practice Procedures | ||||
2018-2019 CMS Allowed Amount Changes | Change | |||
2018 | 2019 | Dollars | % | |
36475 RF ablation first vein
|
$ 1,440.08 | $ 1,361.02 | $ (79.06) | -5% |
36476 RF ablation subsequent vein(s)
|
$ 285.67 | $ 292.23 | $ 6.56 | 2% |
36478 Laser ablation first vein
|
$ 1,152.62 | $ 1,079.86 | $ (72.76) | -6% |
36479 Laser ablation subsequent vein(s)
|
$ 301.03 | $ 307.97 | $ 6.94 | 2% |
36465 Injection foam sclerosant single vein
|
$ 1,498.03 | $ 1,450.73 | $ (47.30) | -3% |
36466 Injection foam sclerosant multiple veins
|
$ 1,567.03 | $ 1,526.78 | $ (40.25) | -3% |
36482 Chemical ablation first vein
|
$ 1,995.35 | $ 1,929.13 | $ (66.22) | -3% |
36483 Chemical ablation subsequent vein(s)
|
$ 140.99 | $ 147.13 | $ 6.14 | 4% |
36470 Sclerotherapy single vein
|
$ 101.72 | $ 102.49 | $ 0.77 | 1% |
36471 Sclerotherapy multiple veins
|
$ 183.24 | $ 186.08 | $ 2.84 | 2% |
93970 Duplex scan vein bilateral
|
$ 187.54 | $ 184.77 | $ (2.77) | -1% |
93971 Duplex scan vein unilateral
|
$ 115.06 | $ 114.53 | $ (0.53) | 0% |
76942 US guidance
|
$ 58.25 | $ 55.34 | $ (2.91) | -5% |
In our next blog/newsletter, we will compare the alternative non-thermal vein ablation techniques with RFA and EVLT to help you understand your vein ablation technique options.
If you have any questions on this or other Vein related topics, please contact your StreamlineMD client rep or sales@streamlinemd.com.