Scope: what is covered
- The circular covers specific medical services by code and assigns each service an RVU for reimbursement under the RVS 2001 framework.
- The circular covers reimbursement claims for vasectomy and tubal ligation by prescribing the specific codes to report.
- The circular is an addendum that extends the existing RVS 2001 coverage through inclusion of additional reimbursable services.
Addendum: newly included reimbursable services
- Code 77401 covers Radiation treatment delivery and is assigned RVU 10.
- Code 79000 covers Radiopharmaceutical (radioactive iodine) therapy and is assigned RVU 10.
- Code 90935 covers Hemodialysis procedure and is assigned RVU 10.
- Code 90945 covers Dialysis procedure other than hemodialysis (e.g. peritoneal, hemofiltration) and is assigned RVU 10.
- Code 93556 covers Imaging supervision, interpretation and report for injection procedures during cardiac catheterization; coronary angiography and is assigned RVU 50.
- Code 96408 covers Chemotherapy administration and is assigned RVU 10.
Special reporting rules for sterilization procedures
- Claims for vasectomy must report code 55250 for Vasectomy, unilateral or bilateral, using the assigned “Package” RVU basis.
- Claims for tubal ligation must report code 58600 for Ligation or transaction of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral, using the assigned “Package” RVU basis.
- The circular requires the prescribed codes to be reported in case of claims for vasectomy and tubal ligation.
Reimbursement instruction
- The circular provides that the listed services are considered inclusion to the RVS 2001, and thus are reimbursable when claimed.
- The circular establishes reimbursement through the code and RVU values shown, including “Package” for the sterilization procedure codes.