Medicare Cuts 88305-TC by 52%

On November 1st, CMS announced multiple physician pay cuts, which will impact pathologists.  Most widely felt is the Technical Component (TC) of CPT 88305, which was cut 52%, while the Professional Component (PC) was increased 2%.  This reduces the overall global payment for this code by 33%.  Other notable codes decreased are: 88300-TC, decreased by 57%; 88304-TC, decreased by 34% and 88311-TC, which was cut 31%.  Increases have been made across the board on each of the respective Professional Components (PC) for each code. 

The effect of this cut will be felt by independent laboratories, private hospital based practices that have global billing arrangements and hospital executives.  The revaluation of this code is not surprising, as focus at CMS has been scrutinizing high volume codes across all specialties.  The TC of 88305 had not been reviewed since it was initially valued in 2000.  APS is actively providing projections of the impact felt by all clients affected.  If you have questions about this or other reimbursement related topics, please contact your Account Representative.