Feature | November 05, 2014

CMS Issues Ruling on 2015 Mammography Screening Reimbursement Rates

Separate codes created for screening mammography versus diagnostic mammography

November 5, 2014 — Hologic, Inc. announced that the Centers for Medicare and Medicaid Services (CMS) has released reimbursement rates for screening and diagnostic 3-D mammography. The action establishes national average payment rates for the Category I Current Procedural Terminology (CPT) code for 3-D screening mammography and creates a new add-on Healthcare Common Procedure Coding System (HCPCS) code for 3-D diagnostic mammography.

The Medicare payment rates will go into effect Jan. 1, 2015, and will allow providers in the United States to file reimbursement claims specific to screening and diagnostic 3-D mammography. The CMS Medicare Physician Fee Schedule Final Rule not only sets reimbursement rates for 3-D mammography, but also creates a pathway for private insurers to explore broader coverage and payment options. The rates are as follows:

  • 3-D screening mammography CPT code, 77063, assigned a payment rate of approximately $57. This is an add-on to the existing 2-D mammography screening code, G0202, with an assigned payment rate of approximately $135.
  • 3-D diagnostic mammography HCPCS code, G0279, assigned a payment rate of approximately $57 for either unilateral or bilateral images.  
    • This is an add-on to the existing 2-D mammography unilateral diagnostic code, G0206, with an assigned payment rate of approximately $130. 
    • This is an add-on to the existing 2-D mammography bilateral diagnostic code, G0204, with an assigned payment rate of approximately $165.

For more information www.hologic.com

Related Content

Fujifilm Installing New DR Equipment for Three Large Healthcare Systems
News | Digital Radiography (DR) | September 22, 2017
Fujifilm Medical Systems U.S.A. Inc. recently closed new contracts to enhance diagnostic imaging capabilities for...
News | Business | September 19, 2017
September 19, 2017 — Invicro LLC, a provider of imaging services and software for research and drug development, anno
News | Imaging | September 18, 2017
Mary Washington Hospital and Union Health-Union Hospital will both receive Safety FiRsT grants to implement safety...
Understanding True Patient-centered Care in Radiology
Sponsored Content | Whitepapers | Imaging | September 18, 2017
What is the true meaning of “patient-centered care”?
Theraclion to Launch Metastatic Breast Cancer Trial Combining Echotherapy and Immunotherapy
News | Focused Ultrasound Therapy | September 18, 2017
September 18, 2017 — Theraclion and co-lead investigator David Brenin, M.D., from the University of Virginia School o
DenseBreast-info.org Debuts  Spanish Language Video  About Dense Breasts
News | Breast Density | September 12, 2017
Breast cancer risks associated with breast density are the subject of a new Spanish language video launched recently by...
ASRT Donating $10,000 in Support of Hurricane Irma Relief Efforts
News | Business | September 12, 2017
September 12, 2017 — The American Society of Radiologic Technologists (ASRT) announced it will donate $10,000 to the
Asian Study Underlines Potential Value of Pressure-Guided Mammography
News | Mammography | September 11, 2017
Sigmascreening recently announced that a study of in total 15,898 in digital mammograms from 3,772 Asian women...
Delphinus Enrolls First Patient in Discover Breast Ultrasound Clinical Project
News | Ultrasound Womens Healthcare | September 08, 2017
September 8, 2017 — Delphinus Medical Technologies Inc.
Breast imaging X-ray mammogram showing a breast tumor. Photo courtesy of Monthian Ritchan-Ad

Photo courtesy of Monthian Ritchan-Ad

Feature | Breast Density | September 08, 2017 | By Roy Prager, M.D.
While mammograms play a vital role in efforts to identify breast cancer, they can present some challenges in women with...
Overlay Init