This article is for technical diagnostic imaging facilities and multi-specialty physician groups caring for our members
Based on our review of claims processed for A9587 (Gallium GA-68, dotatate, diagnostic, 0.1 millicurie), we will update our reimbursement for A9587 on October 1, 2021. On that date, we will move from a global payment to a per unit cost. This change applies to all products.
Code | Current Fee | New rate, effective October 1, 2021 |
---|---|---|
A9587 | $3,604.00 | $66.74 per unit |
Our review of prior claims found that some providers who had billed for more than one unit of A9587 were reimbursed more than the global fee of $3,604. We will retrospectively adjust claims billed with multiple units prior to October 1, 2021 to allow only one unit of service at the current fee ($3,604). If you have affected claims, your claim will be adjusted so that you receive the global payment of $3,604.
MPC_072721-1R-1