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The reformation of Medicare and its effect on pathology
1Department of Pathology, New England Memorial Hospital, Stoneham, MA 02180.
American Journal of Clinical Pathology
|April 1, 1993
Abstract:
Medicare policies have gradually restricted the scope of pathologist services payable under the rules applicable to physician services. Recent changes applying relative value scales has provided an opportunity for national standardization of pathology codes, and has permitted the introduction of clinical pathology interpretations as compensable physician services.
Insights
Medicare is changing how it pays for pathologist services. New rules standardize pathology codes and allow payment for clinical pathology interpretations as physician services.
Area of Science:
- Health Policy
- Medical Economics
- Pathology Services
Background:
- Medicare policies have progressively limited pathologist services reimbursed under physician service rules.
- Recent shifts in Medicare policy present an opportunity for national standardization.
Purpose of the Study:
- To analyze the impact of recent Medicare policy changes on pathology service reimbursement.
- To examine the introduction of clinical pathology interpretations as compensable physician services.
Main Methods:
- Analysis of Medicare policy changes regarding relative value scales.
- Review of national standardization efforts for pathology codes.
- Assessment of the inclusion of clinical pathology interpretations in payable services.
Main Results:
- Medicare policy changes have restricted some pathologist services.
- Relative value scales have enabled national standardization of pathology codes.
- Clinical pathology interpretations are now recognized as compensable physician services.
Conclusions:
- Standardization of pathology codes under new Medicare rules facilitates consistent reimbursement.
- The recognition of clinical pathology interpretations expands payable services for pathologists.
- These changes signify a notable shift in Medicare's approach to compensating pathology expertise.