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2020 Medicare Physician Fee Schedule: New Codes for Physiatry

Members & Publications

August 20, 2019

Effective January 1, 2020, 4 new codes will take effect describing injections and destruction/ablation of the genicular nerve branches and the nerves innervating the sacroiliac joint. These codes describe services our members have been providing for years but, until now, there hasn’t been specific coding to capture this work. These codes are reflective of the hard work of our CPT and RUC advisor teams as well as our continued collaborative efforts with other specialty societies. It is our hope that with the implementation of these new codes our members will experience fewer challenges obtaining coverage for these services. 

The chart below includes the new code language and proposed 2020 Physician Fee Schedule values. The new code numbers will be finalized later this year, but the code language is final. Your Academy will be submitting a comment letter urging CMS to accept higher practice expense RVUs for these services as well as a higher work RVU specifically for the genicular nerve branch destruction code. CMS is accepting comments on the proposed values for these codes through September 27, 2019. 

Code

Descriptor

2020 Proposed wRVU

2020 Proposed Total RVU

64XX0

Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed

1.52

6.04

64XX1

Destruction by neurolytic agent, genicular nerve branches, including imaging guidance, when performed

2.5

9.64

6XX00

Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)

1.52

5.26

6XX01

Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)

3.39

12.20

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.

 

 

 

 

 

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