Washington
Transcription
Washington
Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates View ASC Fee Schedule Updates below. July 2016 Updates per CMS CR 9668 CBSA 50 – Rural Washington CBSA 13380 – Bellingham, WA; Whatcom County, WA CBSA 14740 – Bremerton-Silverdale, Kitsap County, WA CBSA 28420 – Kennewick-Richland-Pasco, WA; Benton and Franklin Counties WA CBSA 30300 – Lewiston, ID-WA; Nez Perce County, ID; Asotin County, WA CBSA 31020 – Longview, WA; Cowlitz County, WA CBSA 34580 – Mount Vernon-Anacortes; Skagit County, WA CBSA 36500 – Olympia, WA; Thurston County, WA CBSA 38900 – Portland-Vancouver-Beaverton, OR-WA; Clackamas, Washington and Yamhill Counties, OR; Clark and Skamania Counties, WA CBSA 42644 – Seattle-Bellevue-Everett, WA; King and Snohomish Counties, WA CBSA 44060 – Spokane and Spokane County, WA CBSA 45104 – Tacoma and Pierce Counties, WA CBSA 47460 – Walla Walla, WA CBSA 48300 – Wenatchee, WA CBSA 49420 – Yakima and Yakima County, WA CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 1 Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates July - For Dates of Service on/after 7/1/16 and processed on/after 7/5/16 CBSA 50: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount FC HCPCS Modifier Amount FB HCPCS Modifier Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,309.60 $0.00 $0.00 $1,283.49 $0.00 $0.00 0440T S $812.88 $0.00 $0.00 $796.67 $0.00 $0.00 0441T S $812.88 $0.00 $0.00 $796.67 $0.00 $0.00 0442T S $812.88 $0.00 $0.00 $796.67 $0.00 $0.00 0443T S $879.35 $0.00 $0.00 $861.80 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 13380: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,423.64 $0.00 $0.00 $1,395.25 $0.00 $0.00 0440T S $883.67 $0.00 $0.00 $866.05 $0.00 $0.00 0441T S $883.67 $0.00 $0.00 $866.05 $0.00 $0.00 0442T S $883.67 $0.00 $0.00 $866.05 $0.00 $0.00 0443T S $955.92 $0.00 $0.00 $936.85 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 14740: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,323.53 $0.00 $0.00 $1,297.13 $0.00 $0.00 0440T S $821.53 $0.00 $0.00 $805.14 $0.00 $0.00 0441T S $821.53 $0.00 $0.00 $805.14 $0.00 $0.00 0442T S $821.53 $0.00 $0.00 $805.14 $0.00 $0.00 0443T S $888.70 $0.00 $0.00 $870.97 $0.00 $0.00 CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 2 Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates CBSA 28420: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount FC HCPCS Modifier Amount FB HCPCS Modifier Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,240.79 $0.00 $0.00 $1,216.05 $0.00 $0.00 0440T S $770.17 $0.00 $0.00 $754.81 $0.00 $0.00 0441T S $770.17 $0.00 $0.00 $754.81 $0.00 $0.00 0442T S $770.17 $0.00 $0.00 $754.81 $0.00 $0.00 0443T S $833.15 $0.00 $0.00 $816.52 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 30300: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,231.70 $0.00 $0.00 $1,207.13 $0.00 $0.00 0440T S $764.53 $0.00 $0.00 $749.28 $0.00 $0.00 0441T S $764.53 $0.00 $0.00 $749.28 $0.00 $0.00 0442T S $764.53 $0.00 $0.00 $749.28 $0.00 $0.00 0443T S $827.04 $0.00 $0.00 $810.53 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 31020: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,305.34 $0.00 $0.00 $1,279.31 $0.00 $0.00 0440T S $810.24 $0.00 $0.00 $794.08 $0.00 $0.00 0441T S $810.24 $0.00 $0.00 $794.08 $0.00 $0.00 0442T S $810.24 $0.00 $0.00 $794.08 $0.00 $0.00 0443T S $876.49 $0.00 $0.00 $859.00 $0.00 $0.00 CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 3 Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates CBSA 34580: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount FC HCPCS Modifier Amount FB HCPCS Modifier Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,218.52 $0.00 $0.00 $1,194.22 $0.00 $0.00 0440T S $756.35 $0.00 $0.00 $741.27 $0.00 $0.00 0441T S $756.35 $0.00 $0.00 $741.27 $0.00 $0.00 0442T S $756.35 $0.00 $0.00 $741.27 $0.00 $0.00 0443T S $818.19 $0.00 $0.00 $801.87 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 36500: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,399.18 $0.00 $0.00 $1,371.27 $0.00 $0.00 0440T S $868.48 $0.00 $0.00 $851.16 $0.00 $0.00 0441T S $868.48 $0.00 $0.00 $851.16 $0.00 $0.00 0442T S $868.48 $0.00 $0.00 $851.16 $0.00 $0.00 0443T S $939.50 $0.00 $0.00 $920.75 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 38900: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,399.74 $0.00 $0.00 $1,371.83 $0.00 $0.00 0440T S $868.83 $0.00 $0.00 $851.51 $0.00 $0.00 0441T S $868.83 $0.00 $0.00 $851.51 $0.00 $0.00 0442T S $868.83 $0.00 $0.00 $851.51 $0.00 $0.00 0443T S $939.87 $0.00 $0.00 $921.12 $0.00 $0.00 CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 4 Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates CBSA 42644: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount FC HCPCS Modifier Amount FB HCPCS Modifier Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,377.79 $0.00 $0.00 $1,350.31 $0.00 $0.00 0440T S $855.21 $0.00 $0.00 $838.15 $0.00 $0.00 0441T S $855.21 $0.00 $0.00 $838.15 $0.00 $0.00 0442T S $855.21 $0.00 $0.00 $838.15 $0.00 $0.00 0443T S $925.13 $0.00 $0.00 $906.67 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 44060: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,381.49 $0.00 $0.00 $1,353.94 $0.00 $0.00 0440T S $857.50 $0.00 $0.00 $840.40 $0.00 $0.00 0441T S $857.50 $0.00 $0.00 $840.40 $0.00 $0.00 0442T S $857.50 $0.00 $0.00 $840.40 $0.00 $0.00 0443T S $927.62 $0.00 $0.00 $909.11 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 45104: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,365.93 $0.00 $0.00 $1,338.69 $0.00 $0.00 0440T S $847.85 $0.00 $0.00 $830.94 $0.00 $0.00 0441T S $847.85 $0.00 $0.00 $830.94 $0.00 $0.00 0442T S $847.85 $0.00 $0.00 $830.94 $0.00 $0.00 0443T S $917.17 $0.00 $0.00 $898.87 $0.00 $0.00 CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 5 Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates CBSA 47460: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount FC HCPCS Modifier Amount FB HCPCS Modifier Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,357.72 $0.00 $0.00 $1,330.64 $0.00 $0.00 0440T S $842.75 $0.00 $0.00 $825.94 $0.00 $0.00 0441T S $842.75 $0.00 $0.00 $825.94 $0.00 $0.00 0442T S $842.75 $0.00 $0.00 $825.94 $0.00 $0.00 0443T S $911.65 $0.00 $0.00 $893.46 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 48300: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,252.96 $0.00 $0.00 $1,227.97 $0.00 $0.00 0440T S $777.73 $0.00 $0.00 $762.22 $0.00 $0.00 0441T S $777.73 $0.00 $0.00 $762.22 $0.00 $0.00 0442T S $777.73 $0.00 $0.00 $762.22 $0.00 $0.00 0443T S $841.32 $0.00 $0.00 $824.53 $0.00 $0.00 FC HCPCS Modifier Amount FB HCPCS Modifier Amount CBSA 49420: HCPCS / CPT Code HCPCS Modifier Procedure Indicator Amount Penalty Price FC Mod Penalty Price FB Mod Penalty Price 0438T S $1,239.91 $0.00 $0.00 $1,215.19 $0.00 $0.00 0440T S $769.63 $0.00 $0.00 $754.28 $0.00 $0.00 0441T S $769.63 $0.00 $0.00 $754.28 $0.00 $0.00 0442T S $769.63 $0.00 $0.00 $754.28 $0.00 $0.00 0443T S $832.56 $0.00 $0.00 $815.94 $0.00 $0.00 CPT codes, descriptors and other data are copyright 2015 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. .© Noridian Healthcare Solutions, LLC Page | 6
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