July 18, 2008
Extension of Payment Rule for Brachytherapy and Therapeutic Radiopharmaceuticals
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA),
enacted on July 15, 2008, extends the use of the cost to charge payment methodology
for Brachytherapy and Therapeutic Radiopharmaceuticals through January 1, 2010.
This change is retroactive to July 1, 2008. Some claims have already been processed,
however, using the Outpatient Prospective Payment System (OPPS) rates that
were in effect until MIPAA enactment. To avoid a disruption in payment while
the cost to charge payment methodology is re-implemented, impacted claims will
continue to be paid based on the OPPS rates. Contractors will mass adjust all
impacted OPPS claims with dates of service beginning July 1, 2008, as soon
as the cost to charge payment methodology has been implemented. Reprocessing
will be complete by September 30, 2008.
