HCFA releases IVUS payment policies

The Health Care Financing Administration has established reimbursementpolicies covering physicians for the use of intravascular ultrasound(IVUS) during therapeutic interventions, according to IVUS developerEndosonics of Rancho Cordova, CA. The policies became effectiveJan. 1.

While third-party payors are increasingly reimbursing for IVUS,the HCFA policies represent the first nationwide healthcare policydecision in the U.S. granting reimbursement to physicians forusing the procedure, the company said.

Under the new policies, physicians can select from six differentcodes for IVUS, such as IVUS for one vessel and then subsequentvessels. In addition, there are also codes for coronary or peripheralvessels.

Guidelines for computing physician reimbursement vary acrossthe nation based on local service cost factors. Current indicationsare that the average reimbursement levels for coronary usage willrange from $95 to $254 for the first vessel and from $74 to $180for each subsequent vessel, depending on the service location(in hospital or outpatient), according to Endosonics.