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Medicare In Brief

This article was originally published in The Gray Sheet

Executive Summary

Neurostimulator payments: Medicare reimbursement for outpatient procedures to implant neurostimulator leads would increase 44% under the agency's proposed 2010 Outpatient Prospective Payment System (OPPS) rule, released July 1. The proposed boost follows a double-digit decrease in payment for the same procedure in 2009, which occurred despite protests from Cyberonics, maker of the Vagus Nerve Stimulation System for controlling epileptic seizures (1"The Gray Sheet" Sept. 1, 2008). CMS says the fluctuations in median costs for implantation of neurostimulator electrodes for the cranial nerve and for insertion of left ventricular pacing electrodes "are a consequence of the small number of single bills upon which the median costs are based and the small number of providers of these services." The agency also plans to consolidate the current three APC codes for neurostimulator generator implantation into two. Comments on the OPPS proposal are due Aug. 31; a final rule is expected by Nov. 1

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