Medicare Reimbursement Policy Update:
Policy Enforcement Clause In Five States

from the April 2004 issue

Now that the local Medicare Carriers in 37 states, the District of Columbia and Puerto Rico have implemented reimbursement policies for non-invasive vascular testing that require or recommend laboratory accreditation or technologist credentialing, many individuals associated with non-invasive vascular laboratories have begun questioning how or if these policies will be enforced. The Medicare Carriers of the Arkansas Consortium that includes Arkansas, Louisiana, Missouri (Eastern), New Mexico and Oklahoma have published a definitive policy to address that question.

Recently, the Medicare reimbursement policy for these states was amended to include the following statement:

"Effective January 1, 2005, documentation of either the RVT or facility accreditation will be required each January prior to billing electronically for that new year and with any and all submitted paper claims. Supervisory levels of diagnostic tests must be in accordance with Program Memorandum B-01-28."

This change in policy lends credence to the fact that local Medicare insurance carriers continue to revise the reimbursement policies and give consideration to the importance of quality and standardization documented in non-invasive vascular laboratories.

In an effort to keep vascular laboratory personnel abreast of the most current information available regarding reimbursement policies, the ICAVL monitors each state on a regular basis and updates our website when changes become finalized. To read the complete reimbursement policy for the states listed above, or any other state, visit the ICAVL website at www.intersocietal.org/icavl/reimbursement/terms.htm and click on the state of interest. In addition to the reimbursement policy, you will find the website link to the individual medical carrier websites which will offer you additional information.

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