Each year, the Centers for Medicare & Medicaid Services (CMS) revises the reimbursement rates for all services. During the review and revision process for the coming year, there’s often at least one or two areas that bring about heated discussion in the private sector over reimbursement, generally because of a reduction or a less-than-wanted/less-than-desired increase. This year, as over the past few years, home oxygen was a hot topic.
In an announcement late this year, CMS announced it was reviewing issues related to sleep apnea, as the number of Medicare claims over the past few years have shot up like rocket. Much of that is attributed to patient education, community awareness, and various outreach efforts, such as those initiated by Awake In America, the National Sleep Foundation, and other organizations.
Most insurance companies use Medicare guidelines, as well as reimbursement rates, for setting their own coverage and reimbursement guidelines. For that reason, many people like to know, but also have a right to know, what the reimbursement rate is for any particular service or medical/health care product.
Awake In America has assembled a list of sleep apnea therapy-related items with the associated minimum and maximum national 2009 reimbursement rates listed. Each item is shown with the Medicare (CMS) description and HCPCS code, which you will find on insurance and Medicare billing and and most explanation of benefit statements.
Reimbursement costs for sleep apnea therapy items, such as CPAP and bi-level (BiPAP) machines, nasal CPAP masks, tubing, heated humidification chambers, heated humidifiers, among others, are listed in the 2009 Medicare Reimbursement Rate file.
You may download the 2009 Sleep Apnea Therapy Medicare Reimbursement Rate file from Awake In America’s site.
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