September 3, 2010
ASTRO submits comments on proposed CY 2011 OPPS Rule

The American Society for Radiation Oncology submitted comments on the CY 2011 Medicare Hospital Outpatient Prospective Payment System (OPPS) regulations to the Centers for Medicare and Medicaid Services (CMS) by the August 31, 2010, deadline. In this letter ASTRO addressed a number of proposals including:

• Packaging of Image Guidance Radiation Therapy (IGRT)
• Expanding the Bypass List
• APC 0303 – Treatment Device Construction
• Payment for High-dose-rate Brachytherapy Treatment
• Payment for Brachytherapy Sources

View ASTRO comment letter

August 30, 2010
ASTRO submits comments on Proposed CY 2011 Medicare Physician Fee Schedule

The American Society for Radiation Oncology submitted comments on the CY 2011 Medicare Physician Fee Schedule to the Centers for Medicare and Medicaid Services (CMS) by the August 24, 2010, deadline. In this letter ASTRO addressed a number of proposals that will impact our membership and the patients they serve including:

• Rebasing and Revising of the Medicare Economic Index (MEI)
• Codes on the Multispecialty Points of Comparison List
• Disclosure Requirements for In-office Ancillary Services Exception to the Prohibition on Physician Self Referral for Certain Imaging Services
• Updating High-cost Supplies – CPT Code 77301
• Alternative Data Sources and Public Comments on Final Rule for 2010
• Proposal to Use GSA Supply Schedule to Regularly Update CMS Supply Schedule
• Updating Equipment and Supply Price Inputs for Existing Codes
• Validating RVUs of Potentially Misvalued Codes
• Physician Quality Reporting Initiative (PQRI)
• Multiple Procedure Payment Reduction (MPPR) Policy to Additional Nonsurgical Services

Read the ASTRO comment letter on CY 2011 Proposed Medicare Physician Fee Schedule

August 23, 2010
ASTRO member appointed to the Medicare Advisory Panel on Ambulatory Payment Classifications Groups 
ASTRO is pleased to announce the appointment of ASTRO member Brian D. Kavanagh, M.D., M.P.H., to the Medicare Advisory Panel on Ambulatory Payment Classification (APC) Groups. Dr. Kavanagh’s appointment is from October 1, 2010, to September 30, 2014. The Panel advises the Centers for Medicare and Medicaid Services on technical issues related to APCs, the payment methodology used in the Medicare Hospital Outpatient Prospective Payment System. 
View ASTRO's press release
View the official announcement from CMS on panel appointments

August 10, 2010
CMS Releases Guidance on Payment for Implantable Tissue Marker (HCPCS Code A4648) and Implantable Radiation Dosimeters (HCPCS Code A4650)
On August 6, 2010 CMS released Change Request 6968 which provides guidance regarding payment for Implantable Tissue Marker (HCPCS Code A4648) and Implantable Radiation Dosimeters (HCPCS Code A4650). This document, effective November 6, 2010, clarifies that HCPCS code A4648 and HCPCS code A4650 are separately billable and payable when used in conjunction with CPT codes 19499, 32553, 49411, or 55876 on a claim for physician services. No separate payment is made for A4648 or A4650 to facilities paid under the hospital outpatient prospective payment system (OPPS), the ambulatory surgical center (ASC) payment systems, or the Medicare inpatient prospective payment system (IPPS) IPPS. Hospitals that are not paid under the OPPS or IPPS are paid for HCPCS code A4648 and HCPCS code A4650 under a variety of other payment mechanisms.
View Change Request 6968.

August 10, 2010
CMS decision memo on PET for initial treatment strategy in solid tumors and myeloma
After careful review, CMS has amended its national coverage determination (NCD) to remove the current absolute restriction to only one fluorodeoxyglucose positron emission tomography (FDG PET) scan to determine the location and/or extent of the tumor for therapeutic purposes related to the initial treatment strategy. CMS will continue to nationally cover one FDG PET scan to determine the location and/or extent of the tumor for the therapeutic purposes related to the initial treatment strategy and will allow local Medicare administrative contractors the discretion to cover (or not cover) within their jurisdictions any additional FDG PET scan for therapeutic purposes related to the initial treatment strategy.
View the CMS memorandum.

August 10, 2010
National Government Services (NGS) Retires LCD for Brachytherapy
NGS, the MAC for jurisdiction 8 (Connecticut and New York), has retired their LCD and Supplemental Instructions Article for brachytherapy services effective August 1, 2010. After a review of their data, it was determined that there was no longer a need for the Brachytherapy local coverage determination (LCD) and supplemental instructions article. All local policy rules, requirements and limitations pertaining to this LCD and article are no longer applied on a prepay basis as claims are now subject to postpay review. All CMS national policy rules, requirements and limitations remain in effect.
View NGS’ Medical Policy Update for more details.

August 10, 2010
2010 Medicare Trustees Report Extends Solvency of Program to 2029
On August 5, the 2010 Medicare Trustees Report was released and concluded that the Medicare Trust Fund will stay solvent until 2019, 12 years longer than estimated in the 2009 report. The report largely credits health care reform legislation passed in March of this year for this improved outlook.
Read the ASTROnews Web exclusive for more details.

July 16, 2010
Summary of 2011 proposed Physician Fee Schedule regulations now available
On June 25, 2010, the Centers for Medicare and Medicaid Services released the proposed 2011 Medicare Physician Fee Schedule (MPFS) regulations.
View a detailed summary highlighting issues relevant to radiation oncologists.