tci Medicare Compliance & Reimbursement - 2004 Issue 20

Oncologists: Oncologists To CMS: Give Us The Bad News First

Legislators write to CMS asking for payment rate information.Physicians who provide chemotherapy services could be facing an uncertain fate next year.  The Medicare Modernization Act cut payments for chemotherapy drugs to 85 percent of average wholesale price in 2004 and set up a transition to average sales price in 2005. To offset these cuts, Congress increased practice expense RVUs for chemotherapy based on survey data collected by the American Society for Clinical Oncology. In addition, the law increased drug administration fees for 2004 by an "adjustment factor" of 32 percent.But in 2005, this adjustment factor falls...

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