From the SVS PAC: Funds Needed to Stop Office-Based Reimbursement Cuts


Sept. 6, 2013

Dear SVS Member:

The Centers for Medicare and Medicaid Services (CMS) is recommending cuts to 15 vascular surgery codes in its Calendar Year 2014 Medicare Physician Fee Schedule Proposed Rule. The proposal would refine the Practice Expense (PE) methodology by capping non-facility (office) PE Relative Value Units for these codes so they would not exceed facility payment under the Hospital Outpatient Prospective Payment System or Ambulatory Surgery Center (ASC) fee schedule, whichever is lower, even though vascular surgeons incur full PE in their offices.

Thirteen of the fifteen vascular surgery codes (CPT 36147, 36566, 37220, 37224-31 and 37234-5) are capped at the ASC rate, which is a formula that does not match up well with payment for vascular surgery procedures performed in an office-based setting. Also significant, the frequency rate of vascular procedures in an ASC is very low. Some of these are never performed in an ASC or are performed at a rate of less than one percent for the total volume in a given year.

The result is a proposed reduction of 18 to 76 percent in PE reimbursement for services performed in vascular surgery office-based angiography suites.

How SVS Members Can Help

You have already been requested to email your House of Representatives member about this issue, asking him/her to call or write CMS in opposition to this. PAC contributions are also critical to help avert these reimbursement cuts by gaining access to as many members of Congress as possible.

We urge every SVS member who has not done so in 2013 to make a contribution to the PAC to ensure the voice of vascular surgery and our patients will be heard on Capitol Hill. You can do this by either completing the contribution form or contributing on-line.

David Deaton, MD, Chair, SVS Political Action Committee

Sean Roddy, MD, Chair, SVS Health Policy Committee


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