September 16, 2020

CMS Releases Inpatient Final Rule

On Sept. 2, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2021 Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital Final Rule. The FY 2021 IPPS final rule makes payment and policy changes under the Medicare IPPS for operating and capital-related costs of acute care hospitals as well as for certain hospitals and hospital units excluded from the IPPS. The policies included in the final rule are effective Oct. 1, 2020.

Of particular interest to radiology and within the final rule, CMS approved the new technology add-on payment for ContaCT. ContaCT analyzes computed tomography angiogram images of the brain acquired in the acute setting, sends notifications to a neurovascular specialists that a suspected large vessel occlusion has been identified and recommends review of those images.

Cases involving the use of ContaCT that are eligible for new technology add-on payments will be identified by ICD–10–PCS procedure code 4A03X5D. New technology add-on payments are limited to the lesser of 65% of the costs of the new medical service or technology, or 65% of the amount by which the costs of the case exceed the MS–DRG payment. CMS has determined the maximum new technology add-on payment for a case involving the use of ContaCT is $1,040 for FY 2021.

If you have any questions, please reach out to Christina Berry at