Blogs

An Overview of CMS 2025 Final Rules – Important Information for the SVU Member

By Randi Sussman posted 25 days ago
By Anne Jones, BSN, RVT, RDMS, FSVU, SVU Advocacy Chair The SVU Advocacy Committee has been busy since July reviewing the Centers for Medicare and Medicaid Services (CMS) annual proposed rulemaking, gathering survey data to formulate a response, submitting comments, and analyzing the final rulemaking for 2025 payment rates. This summary is provided to provide a brief synopsis of the process and outcome. By way of background and as a refresher about terminology, the Balanced Budget Act of 1997 granted authority to CMS to establish a prospective payment system for hospital outpatient services. Further modifications were granted under the Balanced Budget Refinement ...

SVU Advocacy Alert!

By Randi Sussman posted Mon August 26, 2024
The Centers for Medicare and Medicaid Services (CMS) has proposed some important changes to coding for Transcranial Doppler (TCD) studies that will impact your reimbursements starting in 2025. If CMS implements its proposed rule, reimbursement for Complete TCD (93886) and Limited TCD (93888) will fall by nearly 10% . Limited TCD for emboli detection without microbubble (93892) will fall by nearly 15% . Limited TCD for emboli detection with microbubble will fall by over 20% . CMS has also proposed the use of a set of new add on studies to Complete TCD (93886-TC). But, it is unclear whether our membership actually performs these add-on studies. ...

SVU joins SVS on Capitol Hill

By Kelly Byrnes, FSVU, RVT, BS posted Tue June 20, 2023
Pictured left to right: Mike Dalsing, MD (President, SVS), Todd Young (Senator-IN), Kelly Byrnes, RVT (Advocacy Chair, SVU), Kevin Taubman, MD (Member, SVS) The Society for Vascular Surgery (SVS) organized a leadership fly-in on Capitol Hill the day before their Vascular Annual Meeting. On June 13 th , I had the pleasure of joining SVS as the SVU’s Advocacy Chair and representative on the SVS Government Relations Committee. Forty-eight participants representing 22 states joined in more than 90 meetings with members of Congress to discuss payment and workforce issues of concern to our members. Two of the bills we discussed were related to payment reform: ...

CY2023 Medicare Physician Fee Schedule Proposed Rule released

By Kelly Byrnes, FSVU, RVT, BS posted Thu July 14, 2022
The Centers for Medicare & Medicaid Services (CMS) released its 2023 Medicare Physician Fee Schedule (MPFS) Proposed Rule on July 7th. The SVU Advocacy Committee is working with our regulatory counsel, Elizabeth Hardcastle, to analyze and prepare a vascular sonography-specific summary of the proposed rule. We will also be working with the SVS Coding and Reimbursement Committee as we prepare comments. A detailed summary will be provided in the coming days. Topline Summary of 2023 MPFS Proposed Rule CMS estimates a CY 2023 conversion factor of $33.0775 compared to the 2022 conversion factor of $34.6062 CMS is moving forward with year 2 of the 4-year ...

Medicare cuts averted

By Kelly Byrnes, FSVU, RVT, BS posted Tue December 14, 2021
Good news! Congress passed the "Protecting Medicare and American Farmers from Sequester Cuts Act" , a bipartisan legislative package that will mitigate a significant portion of the Medicare-related payment cuts slated for implementation January 1. President Biden signed the legislation into law December 10th. The legislation includes provisions that: Increase the Medicare conversion factor rate for physicians by 3% for calendar year 2022 Push into 2023 the balances on the statutory pay-as-you-go scorecards that would otherwise trigger funding cuts next year. Suspend for three months, through March 31, a 2% automatic cut to Medicare payments ...

CY 2022 MPFS and OPPS Final Rule with Vascular Lab Impact

By Kelly Byrnes, FSVU, RVT, BS posted Mon November 15, 2021
Medicare Physician Fee Schedule The Centers for Medicaid and Medicare Services (CMS) released the calendar year (CY) 2022 Medicare Physician Fee Schedule (MPFS) final rule on November 2 nd . The SVU has created this initial review of provisions within the final rule that affect vascular lab reimbursement. Conversion Factor The CY 2022 conversion factor is $33.59 compared to the 2021 conversion factor of $34.89. The conversion factor reflects the statutory update of zero percent and the adjustment necessary to account for changes in relative value units (RVUs) and expenditures that would result from finalized policies. Last year, Congress provided a 3.75 ...

Advocacy Update Regarding Arterial Duplex and ABI’s Being Recognized as Mutually Exclusive by Insurance Providers

By Joshua Lee, FSVU, MBA, RVT posted Fri June 12, 2020
We have heard from SVU members concerning Aetna, UHC and their seeing arterial duplex and ABI’s as mutually exclusive. The SVU Advocacy Committee and its members have been in contact and fighting this specific battle for approximately a year now. Last year, we were successful in gaining Aetna’s attention to this matter, and they now allow duplex and ABI together for specific codes such as post angioplasty and post stent codes. We are still working very hard to open their eyes and convince them to completely overturn their new policy that places duplex and ABI in a mutually exclusive category. This year, SVU and the Society for Vascular Surgery (SVS) have ...

Great news for SVU!

By Kelly Byrnes, FSVU, RVT, BS posted Fri November 22, 2019
2020 Hospital Outpatient Prospective Payment System and Medicare Physician Fee Schedule Final Rule Here is a summary on the Final Rules recently released by CMS. They contain great news for SVU! In the spirit of Thanksgiving, I would like to recognize the hard work being done by the SVU staff, Board of Directors, Advocacy team, regulatory counsel (Bill Sarraille) and our partnership organizations to secure reimbursement. Thank you for all you do for our profession and members alike! As always, feel free to reach out to me directly or post questions/comments on Uconnect. CMS Final APC Placement for New CPT Codes As proposed, CMS finalized ...

New York Colleagues and anyone who can help.

By Heather Ruttkofsky, RVT posted Mon September 23, 2019
Hello New York Friends! I'm seeking local knowledge on what would be attractive to recruit a highly qualified RVT to work in your area. What should they be looking for in regards to wage, benefits, hours and location(clinical vs Hospital).

CMS Releases Proposed Rules for 2020

By Kelly Byrnes, FSVU, RVT, BS posted Wed August 14, 2019
Calendar Year 2020 Medicare Physician Fee Schedule Proposed Rule On July 29, 2019 the Centers for Medicare and Medicaid Services (CMS) released the 2020 Medicare Physician Fee Schedule (MPFS) Proposed Rule . In this rule, CMS describes changes to payment provisions effective January 1, 2020. Conversion Factor CMS estimates a CY 2020 conversion factor of $36.0896, which is a slight increase from the current conversion factor of $36.0391. Changes to Direct PE Inputs for Specific Services Market-Based Supply and Equipment Pricing Update For CY 2019, CMS contracted with StrategyGen to review and update the pricing for direct practice expense ...

IMPORTANT ADVOCACY UPDATE- 2019 Final Rule

By Kelly Byrnes, FSVU, RVT, BS posted Fri November 09, 2018
YOUR SVU ADVOCACY TEAM DELIVERED! One of the most important investments of your membership dues is the unified voice of our advocacy team. For the third consecutive year, CMS has proposed reimbursement cuts at devastating levels. And for the third consecutive year, SVU successfully fought those cuts and had them removed or reduced from the Final Rule. Complete details can be found on the Advocacy Page on the SVU website. This year, SVU joined our partners at the Society for Vascular Surgery (SVS) to commission an independent report on ultrasound costs and examine cost data gathered by our members. Together, we presented our concerns in person ...

Claims reprocessing: What you need to know

By Kelly Byrnes, FSVU, RVT, BS posted Wed March 28, 2018
We recently posted an article on the SVU website about changes to the Medicare program that affects many of our members. If you are a provider billing Medicare Part B, here is what you need to know: 1) On December 27th, a correction notice (CMS 1678-CN) was issued affecting 3 vascular codes (93880, 93930 and 93978) paid under the Outpatient Prospective Payment System (OPPS). In turn, these changes impacted Part B of the Medicare Physician Fee Schedule (MPFS), since the codes are capped by the OPPS. 2) The MPFS payment files given to Medicare Administrative Contractors (MACs) did not reflect the updated rates in the OPPS, as of January 1st. Therefore, providers ...

Update on Medicare Part B Physician Fee Schedule

By Kelly Byrnes, FSVU, RVT, BS posted Wed March 21, 2018
As you are aware, On December 27th, there was a Correction Notice issued relevant to the CY 2018 Outpatient Prospective Payment System. Of note, it addressed technical errors in the Final Rule that affected three vascular codes (93880, 93930 and 93978). These codes were moved from APC 5522 to APC 5523 changing the payment rates effective January 1st. This also affected the Part B Physician Fee Schedule, since these codes are capped by the APC rates. In January, SVU began receiving inquiries from members who provided vascular services, submitted claims and felt they were being underpaid. At that time, SVU began working with the Medicare Administrative Contractors ...

DEVASTATING CUTS AVERTED!: CMS issues Correction Notice

By Kelly Byrnes, FSVU, RVT, BS posted Tue December 26, 2017
Late Friday, the Centers for Medicaid & Medicare Services (CMS) issued a Correction Notice for the Hospital Outpatient Prospective Payment System (HOPPS). The notice corrected technical errors that appeared in the final rule with comment period published in the Federal Register on December 14, 2017. As a result, these vascular lab codes have been reassigned from APC 5522 (Level 2) to APC 5523 (Level 3): 93880 (Duplex scan of extracranial arteries; complete bilateral study) 93930 (Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study) 93978 (Duplex scan of aorta, inferior vena cava, iliac vasculature, ...

Update on CY 2018 HOPPS

By Kelly Byrnes, FSVU, RVT, BS posted Mon December 18, 2017
The Centers for Medicare and Medicaid Services (CMS) released the 2018 Hospital Outpatient Prospective Payment System (HOPPS) Final Rule on November 1, 2017. CMS made “minor reassignments” (their language) to existing Ambulatory Payment Classifications (APC), resulting in devastating cuts, up to 47% reduction , in reimbursement for four vascular codes. Representatives from the Society for Vascular Ultrasound and the Society for Vascular Medicine met with CMS staff by conference call on Monday, November 20 th . The purpose of the call was to express our deep concerns over the reassignments made to the existing CY 2017 APC groupings, and to see if a mistake ...

Penny for your thoughts

By Kelly Byrnes, FSVU, RVT, BS posted Sun July 23, 2017
Think nobody is listening? You are wrong! I monitor UConnect and other social media sites to learn what you are talking about. I hear you...you are being asked to do more with less. How can I help? One way SVU advocates for the profession is by working with our regulatory counsel at Sidley to get the highest reimbursement for vascular codes. Occasionally, we conduct surveys to collect data for use in our Comment Letters to CMS (Centers for Medicare & Medicaid Services). SVU recently asked members to respond to our survey on Professional Picture Archiving and Communication System (PACS) workstations. Of our 5200 members, we only received 131 responses to ...

Tech..what?

By Kelly Byrnes, FSVU, RVT, BS posted Tue May 30, 2017
To this day, I still see articles and other blogs written about vascular ultrasound that refer to us as technicians. Technician and technologist are two different terms. Many may think they mean the same, since they are used interchangeably. When you look a little closer, however, they are different. The difference is that the technologist has had formal education in the field of vascular ultrasound. Think of it this way, a technician knows which button to push while a technologist knows the why behind pushing it. Simply put, their educational levels and responsibilities differ. We have earned the title of technologist through the advancement in education ...

Venous Insufficiency: A conundrum

By Kelly Byrnes, FSVU, RVT, BS posted Tue May 02, 2017
One of the most frequent questions I get is about reimbursement for chronic venous insufficiency (CVI) exams. Everyone agrees they require more technical expertise and time to complete, right? Then, why don't we get paid more for them? Since I am not an expert on the subject, I turned to two people who are- Joe Zygmunt, RVT, RPhS and William (Bill) Schroedter, RVT, RPhS, FSVU. In an article originally published in the Spring 2016 issue of VEIN Magazine , they discuss this topic in "Venous Duplex: Two Sides of the Coin". In the first part of the article, Joe compares the protocols for venous duplex exams performed to 1) rule out deep vein thrombosis (DVT) and ...

Show Me the Money

By Kelly Byrnes, FSVU, RVT, BS posted Wed February 01, 2017
I want to get paid for my work. I deliver great customer service and high quality noninvasive vascular testing. Don't get me wrong….I can be charitable too. But, I have expenses to cover. The same is true for my employer. Because we want to get paid, it is important to monitor for changes in reimbursement. In this post, I will look at Local Coverage Determinations, or LCDs. An LCD is a determination by a Medicare Administrative Contractor (MAC) that defines coverage for a particular service in the contractor's jurisdiction. LCDs must be consistent with all statutes, rulings, regulations, and national policies for coverage, payment, and coding. LCDs may ...

Comment Letters

By Kelly Byrnes, FSVU, RVT, BS posted Mon January 23, 2017
As promised, this post will look at a website used to find, review and submit comments on Federal rules that are open for comment and published in the Federal Register . In January 2003, Regulations.gov was launched to provide public users access to federal regulatory content. In the past, if members of the public were interested in commenting on a regulation, they would need to know the sponsoring agency, when it would be published, review it in a reading room, and then adhere to the comment process specific to each agency. Regulations.gov removed the logistical barriers that made it difficult for a citizen to participate in the complex regulatory ...