Changes to the Reimbursement for Physician Pathology, Medicine and Surgical Services with a Professional (26) and Technical (TC) Component

Effective for dates of service September 7, 2015 and forward, the Department of Social Services is revising the reimbursement for the professional and technical components of select pathology, medicine and surgical services to 57.5% of the 2007 Medicare Physician Fee Schedule. The Department is implementing this change in order to establish a pricing methodology consistent with Medicare, where, for a given service that includes a professional and technical component, the fee for the professional component, added together with the fee for the technical component, equals the global fee. The services impacted include select pathology services billed under the LAB rate type off of the Physician Office and Outpatient Fee Schedule that have been identified as including a professional and technical component on the Medicare Physician Fee Schedule.  In addition to changes to the professional and technical components, there are 68 codes that will also have an updated global fee. This update to the global fee is necessary because the current fees for the professional and technical components, when added together, do not equal the global fee.

 

Source: https://www.ctdssmap.com/CTPortal/Information/Get Download File/tabid/44/Default.aspx?Filename=pb15_62.pdf&URI=Bulletins/pb15_62.pdf