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Physician Fee Schedule In Brief

This article was originally published in The Gray Sheet

Executive Summary

CardioNet fails to gain national reimbursement rate: Wireless medical technology firm CardioNet is disappointed with the calendar 2011 Physician Fee Schedule proposed by CMS on June 25, which leaves payment for the firm's MCOT Mobile Cardiac Outpatient Telemetry services to the discretion of local Medicare contractors. "We will work diligently during the public comments period to request that CMS change its recommendation to one that is more beneficial to Medicare recipients who depend on MCOT," CardioNet CEO Joe Capper said in a June 28 news release. The company said it will address the matter further when it releases its second-quarter 2010 results in late July. Late last summer, Medicare contractor Highmark dropped reimbursement for MCOT by one-third (1"The Gray Sheet" Sept. 7, 2009)

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CardioNet takes a pay cut

Firm will provide additional information to Medicare contractor Highmark Medicare Services in support of improved reimbursement for its MCOT mobile cardiac outpatient telemetry technology following a payment cut by Highmark of 33% - to $754 from $1,123 per service, effective Sept. 1. HMS has agreed to review new information in a reasonable amount of time, CardioNet says. The firm will also pursue higher reimbursement directly through CMS, the company says. CardioNet, which went public in March 2008, says it first learned of Highmark's plan to lower reimbursement on July 10 (1"The Gray Sheet" March 24, 2008)

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