As a Medicare Administrative Contractor (MAC) - priced service, the MAC must initially determine payment for portable X-ray transportation service that is associated with the cost of providing the service. Factors include the cost of the vehicle, vehicle modifications, gasoline and the staff time involved in only transportation for the portable X-ray service. Please refer to CMS Internet Only Manual (IOM) 100-04, Medicare Claims Processing Manual, Chapter 13, Section 90, for regulations regarding these services. Per the IOM, a re-evaluation of this service should be performed every 5 years.
On September 14, 2018, Novitas sent out a listserv and posted a survey asking for cost information from all Radiology Providers. A message was posted to the Radiology Services Specialty page of our website outlining the IOM regulations, explaining what information was required, and indicating that our fee may change as a result of the responses. The survey remained posted until October 31, 2018. Novitas received 3 responses and the information submitted was insufficient to perform a cost analysis.
On February 13, 2019, Novitas sent out another listserv and re-opened the survey. A message was posted on the Radiology Services Specialty page of our website explaining that we were conducting our 5-year re-evaluation and asking suppliers to provide cost data. We indicated again that our fee may change as a result of the responses. We asked for responses by April 1, 2019. We received no responses to the survey.
On April 9, 2019, Novitas mailed letters to every enrolled Portable X-ray Supplier, asking for cost data so that we could determine an appropriate fee for these services. Our letter outlined the IOM regulations, directed providers to the location of our survey, and advised that our fees may change as a result of the cost analysis. We received 27 responses to the survey.
Novitas’ Provider Audit and Reimbursement Department (PARD) analyzed the cost data which was submitted by the 27 Portable X-ray Suppliers. Their analysis concluded that the appropriate fee for this service in both jurisdictions (JL and JH) is $113.19.
As a result of this 5-year re-evaluation, Novitas planned to update the fees for codes R0070 and R0075 effective January 1, 2020; however, this update is on hold.
We would like to again extend the opportunity for those who have not completed the survey to provide the requested information. Please submit the Transport of Portable X-ray Equipment Survey no later than March 31, 2020. At that time, a final determination will be made on the re-evaluation of the payment for portable X-ray transportation services and another update will be posted here.
If you have questions regarding this instruction please contact MedicalAffairs@novitas-solutions.com.
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