Locate Your 2008 Medicare Rate

Physician Practice Allowables:

This FREE tool will allow you to look up 2008 Medicare rates for practices in all 50 states.  This service is provided by The Centers for Medicare and Medicaid Services.  You will be redirected to their website.  Accept the CMS copyright restrictions at the bottom of the CMS entry page and then follow their instructions on subsequent pages to look up Medicare allowables.  It's fast and easy!  Didn't know this information was publicly available?  Just think what other keys to practice success that MediCo holds!  Need all the rates for your locality in one spreadsheet? Call us at (913) 851-1887 for more information.

Search for Medicare Allowables

Ambulatory Surgery Center Allowables:

This FREE tool will allow you to view 2008 ASC Medicare rates.  MediCo Unlimited works with many ASCs to improve performance through better contracting with payors and understanding your market.  Call us to learn more about how we can help your ASC. 

New beginning 2008:

From ascassociation.org: On November 1, 2007, the Centers for Medicare and Medicaid Services (CMS) released its final rule establishing the ASC payment rates and the ASC list of payable procedures that applies to services provided on or after January 1, 2008. This rule finalized the ASC payment rates for ASCs and HOPDs that were proposed in August 2007. For 2008, ASCs are paid 65% of the hospital outpatient department (HOPD) payments. Much like the previous Medicare payment system, the current system pays ASCs a facility fee intended to cover the costs associated with providing a surgical procedure. Instead of being called groupers as the classifications used for ASC payment were previously known, these payment groups are now known as ambulatory payment classifications, or APCs. Medicare uses the same APCs for ASCs as are used for HOPDs. 

Each CPT® code that an ASC can use is now assigned to an APC, and each APC has a specific payment rate. Although CMS uses APCs to determine the rates that are paid, CMS reports the payment rates by CPT code. Thus, there is no need for ASCs to ascertain which APC a particular procedure is in. As with the prior system, the nationally determined ASC are adjusted to reflect differences in local costs using local wage indexes. However, now 50% of the national rate is adjusted by the local wage index. Previously only 34.45% of the rate was adjusted by the local wage index. 

In its final rule, CMS established a four-year transition to the new rates for procedures currently on the ASC list, a process that gives individual ASCs more time to adjust to the new payment system than an immediate transition to the full system would have provided. 2008 Medicare ASC payments are a blended rate based on 75% of the 2007 ASC rate and 25% of the amount Medicare would have paid in 2008 if the transition had not been adopted. In 2009, the ASC rate will be based 50% on the 2007 rate and 50% on what the 2009 rate would be if the transition had not been adopted. In 2010, the payment will be made based on 25% and 75% of those respective payment rates, and in 2011, the transition will be complete.

Go here to view all the 2008 ASC payment tables:

http://www.cms.hhs.gov/ASCPayment/01_Overview.asp

MediCo Unlimited, LLC is not responsible for any errors, omissions, use or nonuse related to this information.  See our legal notice.  If you find any errors, please notify us.