Reimbursement and Practice Management
On April 14, 2015, Congress repealed the sustainable growth rate (SGR) formula. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently eliminates SGR and provides positive annual payment updates lasting through 2019. Since MACRA significantly changes the way Medicare pays physicians, we have developed a MACRA Resource Page to help educate neurosurgeons about this topic. In addition to our efforts on MACRA, the Coding and Reimbursement Committee is actively involved in bringing or reviewing new or revised CPT codes, is a strong advocate for appropriate valuation of neurosurgical services and neurosurgery’s Rapid Response Team works tirelessly to ensure that third party payors cover necessary neurosurgical services.
Key Resources
Article
Protecting People From Surprise Medical Bills ActCongressman Ruiz, M.D. & Congressman Roe, M.D.Section by Section Section 1: Title“Protecting People From Surprise Medical Bills Act” Section 2: Prohibition on Surprise Balance […]
Letters
SUBJECT: STOP Surprise Medical Bills Act Dear Senators Cassidy, Bennet, Young, Hassan, Murkowski and Carper: On behalf of the American Association of Neurological Surgeons (AANS) and the Congress ofNeurological Surgeons […]
Article
The Alliance of Specialty Medicine (“Alliance”) is a coalition of fifteen medical specialtysocieties representing more than 100,000 physicians and surgeons from specialty andsubspecialty societies dedicated to the development of sound […]
Letters
Dear Leader McConnell, Leader Schumer, Speaker Pelosi and Leader McCarthy, The undersigned organizations appreciate the need to address the issue of surprise billing. Withmemberships dedicated to providing safe and effective […]
Letters
Published: April 29, 2019
Dear Administrator Verma: The undersigned organizations constitute the overwhelming majority of health care professionalswho order or furnish advanced diagnostic imaging tests. While committed to consultation ofappropriate use criteria (AUC) for […]
Letters
Published: April 23, 2019
Dear Chairman Neal, Ranking Member Brady, Chairman Pallone, and Ranking Member Walden: The undersigned organizations write to express our strong opposition to H.R. 2143, the “PromotingIntegrity in Medicare Act.” If […]
Letters
SUBJECT: NASS Draft Model Coverage Policy on Interspinous Fixation with Fusion Dear Dr. Wang: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of NeurologicalSurgeons (CNS) and […]
Letters
SUBJECT: NASS Draft Model Coverage Policy on Lumbar Discectomy Dear Dr. Wang: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of NeurologicalSurgeons (CNS) and the AANS/CNS […]
Letters
Published: March 27, 2019
Subject: Washington State Health Care Authority Proposal for Re-review of VagusNerve Stimulation (VNS) for Epilepsy and Depression Dear Mr. Morse: On behalf of the American Association of Neurological Surgeons (AANS), […]
Letters
Published: February 20, 2019
Subject: Washington State Health Care Authority Non-coverage for Sacroiliac JointFusion Surgery Dear Mr. Morse: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of NeurologicalSurgeons (CNS), the […]
Letters
Published: February 19, 2019
Dear Administrator Verma: The undersigned organizations are writing to urge the Centers for Medicare & Medicaid Services(CMS) to provide guidance to Medicare Advantage (MA) plans on prior authorization (PA)processes through […]
Letters
Published: February 7, 2019
Dear Representative Roe: Thank you for the letter regarding the use of prior authorization in Medicare Advantage (MA).appreciate hearing your views on this issue. Medicare law and regulations allow MA […]
Letters
Published: January 28, 2019
RIN 0938–AT92. Modernizing Part D and Medicare Advantage To Lower Drug Prices and Reduce Outof-Pocket Expenses. 83 Federal Register 231 (November 30, 2018) (“Proposed Rule”) Dear Administrator Verma: On behalf […]
Letters
Published: January 25, 2019
RE: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-pocket Expenses Dear Ms. Verma, On behalf of more than 100,000 specialty physicians from 15 specialty and […]
Article
Published: January 1, 2019
H. R. ____ To amend title XVIII of the Social Security Act to establish requirementswith respect to the use of prior authorization under Medicare Advantageplans, and for other purposes. _______________ […]
Article
Published: January 1, 2019
Medicare Physician Fee Schedule Final Rule Summary On Nov. 1, 2019, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year(CY) Medicare Physician Fee Schedule (MPFS) Final Rule. […]
Letters
Published: January 1, 2019
September 10, 2018 SUBMITTED ELECTRONICALLY VIAhttp://www.regulations.gov Seema VermaAdministratorCenters for Medicare & Medicaid Services,Department of Health and Human Services,Attention: CMS-1693-PMail Stop C4-26-057500 Security BoulevardBaltimore, Maryland 21244-1850 Re: Medicare Program; Revisions to […]
Letters
Published: January 1, 2019
December 6, 2019 Seema VermaAdministratorCenters for Medicare & Medicaid Services,Department of Health and Human Services,Attention: CMS-1715-PP.O. Box 8016Baltimore, MD 21244-8016 Re: CMS-1715-F – Medicare Program; CY 2020 Revisions to Payment […]
Letters
Published: December 19, 2018
Subject: CMS Proposed Decision Memo for Vagus Nerve Stimulation (VNS) for Treatment Resistant Depression (TRD) (CAG-00313R2) Dear Ms. Jensen: The American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons […]
Article
Published: November 22, 2018
On November 1, 2018, the Centers for Medicare & Medicaid Services(CMS) released the Revisions to Payment Policies under Physician FeeSchedule and Other Revisions to Part B for CY 2019; Medicare […]
Article
Published: November 18, 2018
Overview of Coverage Policies on Which Neurosurgery Commented: 2017 and 2018 Preview not available… Read full article here
Article
Published: November 18, 2018
Overview On July 25, 2018, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2018 Hospital Outpatient ProspectivePayment System (OPPS) and ASC Payment System proposed rule. […]
Letters
Published: November 18, 2018
Table of Contents MEDICARE SEVERITY DIAGNOSIS-RELATED GROUP (MS-DRG) CLASSIFICATIONS AND RELATIVE WEIGHTS …………………………………………………….3MS-DRG DOCUMENTATION AND CODING ADJUSTMENT………………………………………………………………………………………………………………………………3SPECIFIC MS-DRG CLASSIFICATIONS ……………………………………………………………………………………………………………………………………………………………………………………..3ADD-ON PAYMENTS FOR NEW SERVICES AND TECHNOLOGIES ……………………………………………………………………………………………………………………….10CHANGES TO MS-DRGS SUBJECT […]
Article
Published: November 18, 2018
OverviewOn November 1, 2018, the Centers for Medicare and Medicaid Services (CMS)released the CY 2019 Medicare Physician Fee Schedule Final Rule and Interim FinalRule. This major final rule includes updates […]
Letters
Published: November 9, 2018
Subject: Washington State Health Care Authority Draft Technology Report onSacroiliac Joint Fusion Dear Mr. Morse: On behalf of the American Academy of Orthopaedic Surgeons (AAOS), American Association ofNeurological Surgeons (AANS), […]
