Washington

Transcription

Washington
Jurisdiction F Medicare Ambulatory Surgical Center (ASC) Fee Updates
View ASC Fee Schedule Updates below.
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July 2016 Updates per CMS CR 9668
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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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