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‘No fee increases at CHC’
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Posted on Feb 18 2009
The Department of Public Health yesterday clarified that it has not raised its fees but has only put prices on certain services and procedures on its schedule of fees that were not used previously by medical providers.
Esther Muna, chief financial officer at DPH, yesterday said there are hundreds of procedures in the current procedural terminology structure and not all are used by Commonwealth Health Center providers and therefore not “priced.”
She said CHC must publish amended regulations to add a CPT code that best describes the procedure not listed on the current schedule of fees.
For example, a procedure called the “repair blood vessel lesion direct; hand, finger” with CPT code 35207 is listed as having a physician/professional fee/component of $1,427.07 and $5 for technical/facility fee component.
Muna said this fee was not included in the last publication of fee schedule in October 2007.
“An amendment is necessary to ‘add’ fees to the current fee schedule,” she said. “CHC did not increase their rates since the last publication in October 2007.”
The CPT codes determine the structure of the fees at CHC. Recent changes make it necessary for CHC to make amendments to its schedule of fees, as described by the CPT structure.
CHC physicians do not necessarily perform services listed in the CPT Manual. Therefore, when physicians find services and procedures are necessary for the medical care of the patient, CHC must price them and include them on the schedule of fees.
On Jan. 23, Health Secretary Joseph Kevin Villagomez approved emergency regulations amending CHC’s schedule of fees.
“These rules and regulations provide for the adoption of new and amended rates for the services and procedures provided at the Commonwealth Health Center. Specifically, they provide that services and procedures are priced for billing purposes,” the regulations state.
The emergency regulations became effective immediately upon filing with the Commonwealth Register on Jan. 28 and delivery to Gov. Benigno R. Fitial on the same date.
