Post by
Desi2019 on May 25, 2021 2:44pm
Which code does VMD bill for NIV?
According to this report, E0464 (pressure ventilation) is the billing code that went up a lot, whereas the other ones were stable (see page 5 graph). The E0464 billing code is ~ $1300 a month and this is higher than average per patient revenue mentioned by VMD (~$900). Is it fair to assume that most VMD billing code are E0461? This latter one didn't change much.
https://oig.hhs.gov/oei/reports/oei-12-15-00370.pdf
Comment by
lscfa on May 25, 2021 3:24pm
There was a 33% cut in reimbursement rates beginning 2016.
Comment by
JackLambert on May 25, 2021 3:31pm
LSFCA - might this mean in your view there is nothing left to cut in reimbursement rates across the industry?
Comment by
Desi2019 on May 25, 2021 3:32pm
I still don't understand how this is a problem for vent suppliers like VMD as it is the prescriber (physician) who decides if NIV is indicated and they take that medical/legal responsibility. As long as the matching machine is used (i.e. not billing for vent when a CPAP is actually being used) I can't see how they can prove any supplier actually overbilled.