What Happens When 66 New Codes Arrive Without a Price?
The October physician fee schedule update went to your MAC on August 21 and to the public on the 27th. Inside: 112 code records, six of them nationally priced, 58 new Category III codes the contractor prices off your operative report, six skin substitutes joining the $127 sheet rate, ten drug codes going invalid with three of their replacements dosed in different units, and one record back-dated to May in a year CMS just told contractors not to reprocess.
Your MAC has had the October payment file since August 21.
The change request announcing it came out on the 27th, and nothing in it takes effect in your remittance until October 5.
Six weeks of lead time exist in that gap, and this quarter's file is worth spending them on: 112 code records land on October 1, and six of them arrive with a price Medicare set nationally.
The rest of this brief is for subscribers.
The impact tables, the code-level detail, and the rest of the analysis sit past this line.
$50 a month, or $500 a year.
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