2019 Medicare Physician Fee Schedule -Final Relative Value Units and Payment Rates for Nuclear Cardiology Procedures

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1 Myocardial Perfusion Imaging 0482T Absolute quant. Myocardial blood flow, PET PE Malpractice Total Conversion Factors $ $ G SPECT MPI, single $ $ % TC SPECT MPI, single $ $ % SPECT MPI, single $ $ % G SPECT MPI, multiple $ $ % TC SPECT MPI, multiple $ $ % SPECT MPI, multiple $ $ % G Planar MPI, single $ $ % TC Planar MPI, single $ $ % Planar MPI, single $ $ % G Planar MPI, multiple $ $ % TC Planar MPI, multiple $ $ % Planar MPI, multiple $ $ % 0331T new July 1, 2013 Heart sympathetic image planar s and Allowables Compared to CY Medicare Physcian Fee Schedule (MPFS) Nuclear Cardiology Procedures, Radiopharmaceuticals and Drugs CMS Website MPFS CY Rule Updated November 2018 Total 0332T new July 1, 2013 Heart sympathetic image planar SPECT Revised: November *CPT codes copyright by the AMA. Page 1 of 7

2 Stress Test Codes Stress Test - physician supervision, with interpretation and report Stress test - physician supervision only, without. Stress test - tracing only, without interpretation and report Stress test - interpretation and report only G TC G TC Cardiac PET* G* Heart muscle imaging (PET) n/a PE Malpractice Total Total $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % $ $ % TC* Heart muscle imaging (PET) n/a n/a n/a Heart muscle imaging (PET) $ $ % G* Heart Image (PET), single n/a TC* Heart Image (PET), single n/a n/a n/a Heart Image (PET), single $ $ % G* Heart image (PET), mult. n/a TC* Heart image (PET), mult. n/a n/a n/a Heart image (PET), mult $ $ % Cardiac MRI G Cardiac mri for morph $ $ % Revised: November *CPT codes copyright by the AMA. Page 2 of 7

3 PE Malpractice Total Total TC Cardiac mri for morph $ $ % Cardiac mri for morph $ $ % G Cardiac mri w/stress img $ $ % TC Cardiac mri w/stress img $ $ % Cardiac mri w/stress img $ $ % G Cardiac mri for morph w/dye $ $ % TC Cardiac mri for morph w/dye $ $ % Cardiac mri for morph w/dye $ $ % G Card mri w/stress img & dye $ $ % TC Card mri w/stress img & dye $ $ % Card mri w/stress img & dye $ $ % G Card mri veloc flow mapping $ $ % TC Card mri veloc flow mapping $ $ % Card mri veloc flow mapping $ $ % Cardiac CT G CT hrt w/o dye w/ca test $ $ % TC CT hrt w/o dye w/ca test $ $ % CT hrt w/o dye w/ca test $ $ % G CT hrt w/3d image $ $ % TC CT hrt w/3d image $ $ % CT hrt w/3d image $ $ % Revised: November *CPT codes copyright by the AMA. Page 3 of 7

4 PE Malpractice Total Total G CT hrt w/3d image $ $ % TC CT hrt w/3d image $ $ % CT hrt w/3d image $ $ % G CT hrt angio w/3d image $ $ % TC CT hrt angio w/3d image $ $ % CT hrt angio w/3d image $ $ % Echocardiography G Tte w/ doppler complete $ $ % TC Tte w/ doppler complete $ $ % Tte w/ doppler complete $ $ % G Tte w/o doppler complete $ $ % TC Tte w/o doppler complete $ $ % Tte w/o doppler complete $ $ % G TC G TC cv ; cv ; $ $ % $ $ % $ $ % $ $ % $ $ % Revised: November *CPT codes copyright by the AMA. Page 4 of 7

5 cv ; PE Malpractice Total Total $ $ % Notes: CMS continues to elect to reimburse for Cardiac PET by setting a price for the service. This service is also subject to the DRA which Limits the payment under the physician fee schedule for performing certain imaging services to the payment amount determined under the outpatient prospective payment system. * After the code signfies that the HOPPS cap applies to the payment rate. Revised: November *CPT codes copyright by the AMA. Page 5 of 7