August 02, 2018

Planned Fee Cuts Modified for Robotic Radiosurgery

Noridian Healthcare Solutions Medicare has cancelled a reimbursement cut for robotic stereotactic radiosurgery/stereotactic body radiation therapy (SRS/SBRT) planned for January 1, 2019, and substantially reduced cuts implemented on July 1, 2018, for procedures applicable to Medicare Administrative Contractor (MAC) Jurisdiction E.

At the urging of the American College of Radiology (ACR) and other radiation oncology stakeholders, Noridian modified its planned policy changes for Jurisdiction E several times since April when it first announced a 60 percent cut for SRS/SBRT services in the jurisdiction. The change would have discontinued the use of G0339 and G0340 for SRS/SBRT, effective July 1, and would have also cross-walked these codes to CPT codes 77372 Stereotactic radiosurgery, linear based and 77373 Stereotactic body radiation therapy, respectively.

On June 20, Noridian announced the July 1 cut would be rolled back to 20 percent until Jan. 1, 2019, when the entire 60 percent rate reduction would be implemented. But that planned policy was changed again in a July 19 announcement, which informed providers that it had postponed the second-stage 40 percent cut indefinitely.

The ACR and the radiation oncology community applauds Noridian for listening to feedback from its Contractor Advisory Committee representatives, physicians and other stakeholder groups about this significant policy change. Future changes to reimbursement for these services will be announced through MAC and/or during Medicare payment policy rulemaking cycles.