OsteoGram®: Reimbursement

Introduction Reimbursement Downloads Reimbursement chart Brochure (DICOM) Brochure (FILM) Osteoporosis- A Silent Disease Formats DICOM Film-Based Version Technology Who Can Use It History RA technique Comparison Publications Clinical Studies Specifications The Process BMD Report Customer Support Taking Hand X-rays Connecting the System HEDIS 2004 Future Applications Arthritis OsteoClick FAQ Related Shows/Meetings Links

Medicare reimburses imaging procedures differently based on the site of care. The technical component (TC) of procedures performed in an Independent Diagnostic Testing Facility (IDTF) or a physician’s office is reimbursed under the Medicare Physician Fee Schedule (MPFS). In a hospital outpatient department, the technical component of a procedure is often reimbursed under an Ambulatory Payment Classification assignment under Medicare’s Hospital Outpatient Prospective Payment System (OPPS). While this does not typically apply to screening tests, it does apply to bone density studies. The professional component is reimbursed under the MPFS regardless of the setting. For 2008 IDTF or a physician office Hospital outpatient Dept CPT 77083 APC 0261 Locality  State & Area tech. pro. global tech. pro. global National Average $22.09 $9.52 $31.61 $73.89 $9.52 $83.41 51000 AL ALABAMA $18.33 $9.03 $27.37 $61.30 $9.03 $70.33 51101 GA ATLANTA, GA $22.95 $9.66 $32.62 $76.76 $9.66 $86.43 51199 GA REST OF GEORGIA $19.42 $9.20 $28.62 $64.95 $9.20 $74.15 51200 MS MISSISSIPPI $18.54 $9.08 $27.63 $62.02 $9.08 $71.10 52013 AR ARKANSAS $17.77 $8.94 $26.71 $59.40 $8.94 $68.34 52105 NM NEW MEXICO $19.81 $9.26 $29.07 $66.27 $9.26 $75.53 52200 OK OKLAHOMA $18.18 $9.00 $27.17 $60.76 $9.00 $69.76 52301 MO2 METROPOLITAN ST. LOUIS, MO $20.94 $9.39 $30.33 $70.05 $9.39 $79.44 52399 MO2 REST OF MISSOURI $18.18 $9.07 $27.25 $60.81 $9.07 $69.88 52401 RI RHODE ISLAND $22.80 $9.79 $32.59 $76.24 $9.79 $86.03 52801 LA NEW ORLEANS, LA $22.12 $9.54 $31.65 $73.98 $9.54 $83.51 52899 LA REST OF LOUISIANA $19.26 $9.20 $28.45 $64.43 $9.20 $73.62 59003 FL FORT LAUDERDALE, FL $24.01 $9.90 $33.91 $80.41 $9.90 $90.31 59004 FL MIAMI, FL $26.52 $10.31 $36.83 $88.89 $10.31 $99.20 59099 FL REST OF FLORIDA $21.75 $9.56 $31.31 $72.81 $9.56 $82.37 59100 CT CONNECTICUT $25.58 $10.17 $35.74 $85.53 $10.17 $95.69 63000 IN INDIANA $19.39 $9.14 $28.52 $64.81 $9.14 $73.95 65000 KS KANSAS $18.99 $9.11 $28.10 $63.48 $9.11 $72.59 65500 NE NEBRASKA $18.46 $9.00 $27.46 $61.69 $9.00 $70.70 66000 KY KENTUCKY $18.74 $9.10 $27.84 $62.66 $9.10 $71.76 74002 MO1 METROPOLITAN KANSAS CITY, MO $21.40 $9.45 $30.85 $71.59 $9.45 $81.04 74004 MO JOHNSON & WYANDOTTE, KANSAS*  $18.99 $9.11 $28.10 $63.48 $9.11 $72.59 74099 MO1 REST OF MISSOURI* $18.18 $9.07 $27.25 $60.81 $9.07 $69.88 80199 NY1 REST OF NEW YORK $19.59 $9.16 $28.75 $65.48 $9.16 $74.64 80301 NY2 MANHATTAN, NY $28.59 $10.74 $39.33 $95.62 $10.74 $106.36 80302 NY2 NYC SUBURBS/LONG I., NY $28.80 $10.71 $39.52 $96.36 $10.71 $107.07 80303 NY2 POUGHKPSIE/N NYC SUBURBS, NY $23.61 $9.79 $33.40 $78.97 $9.79 $88.76 80501 NJ NORTHERN NJ $26.70 $10.44 $37.15 $89.30 $10.44 $99.74 80599 NJ REST OF NEW JERSEY $24.67 $10.11 $34.77 $82.49 $10.11 $92.60 82401 CO COLORADO $21.63 $9.42 $31.05 $72.31 $9.42 $81.74 82600 IA IOWA $18.51 $9.03 $27.54 $61.86 $9.03 $70.89 83101 AK ALASKA $23.74 $9.80 $33.54 $79.38 $9.80 $89.18 83301 HI HAWAII/GUAM $24.33 $9.74 $34.07 $81.35 $9.74 $91.09 83400 NV NEVADA $22.94 $9.64 $32.59 $76.75 $9.64 $86.39 83501 OR PORTLAND, OR $21.80 $9.41 $31.21 $72.84 $9.41 $82.25 83599 OR REST OF OREGON $19.56 $9.14 $28.70 $65.36 $9.14 $74.50 83602 WA SEATTLE (KING CNTY), WA $23.82 $9.77 $33.60 $79.65 $9.77 $89.42 83699 WA REST OF WASHINGTON $21.13 $9.37 $30.50 $70.64 $9.37 $80.01 86501 PA METROPOLITAN PHILADELPHIA, PA $25.09 $10.05 $35.14 $83.95 $10.05 $94.00 86599 PA REST OF PENNSYLVANIA $20.24 $9.30 $29.54 $67.69 $9.30 $76.99 88001 SC SOUTH CAROLINA $18.94 $9.07 $28.01 $63.31 $9.07 $72.37 88300 OH OHIO $20.86 $9.40 $30.26 $69.80 $9.40 $79.20 88416 WV WEST VIRGINIA $19.35 $9.28 $28.63 $64.78 $9.28 $74.06 90009 TX BRAZORIA, TX $21.40 $9.61 $31.01 $71.60 $9.61 $81.21 90011 TX DALLAS, TX $22.90 $9.69 $32.59 $76.61 $9.69 $86.30 90015 TX GALVESTON, TX $21.68 $9.52 $31.19 $72.54 $9.52 $82.06 90018 TX HOUSTON, TX $22.70 $9.75 $32.45 $75.96 $9.75 $85.72 90020 TX BEAUMONT, TX $20.02 $9.34 $29.36 $67.00 $9.34 $76.34 90028 TX FORT WORTH, TX $21.65 $9.48 $31.14 $72.43 $9.48 $81.92 90031 TX AUSTIN, TX $22.35 $9.55 $31.90 $74.77 $9.55 $84.31 90099 TX REST OF TEXAS $19.68 $9.26 $28.95 $65.86 $9.26 $75.12 90101 MD BALTIMORE/SURR. CNTYS, MD $23.50 $9.77 $33.27 $78.61 $9.77 $88.37 90199 MD REST OF MARYLAND $21.35 $9.41 $30.76 $71.39 $9.41 $80.80 90201 DE DELAWARE $22.33 $9.59 $31.92 $74.67 $9.59 $84.26 90301 DC DC + MD/VA SUBURBS $26.78 $10.37 $37.15 $89.55 $10.37 $99.92 90400 VA VIRGINIA $20.16 $9.24 $29.40 $67.41 $9.24 $76.65 95100 WI WISCONSIN $19.70 $9.18 $28.88 $65.85 $9.18 $75.04 95212 IL EAST ST. LOUIS, IL $22.10 $9.65 $31.75 $74.00 $9.65 $83.65 95215 IL SUBURBAN CHICAGO, IL $25.16 $10.09 $35.25 $84.22 $10.09 $94.31 95216 IL CHICAGO, IL $25.88 $10.27 $36.15 $86.65 $10.27 $96.92 95299 IL REST OF ILLINOIS $19.98 $9.32 $29.30 $66.87 $9.32 $76.18 95301 MI DETROIT, MI $25.54 $10.37 $35.91 $85.54 $10.37 $95.92 95399 MI REST OF MICHIGAN $21.06 $9.45 $30.52 $70.49 $9.45 $79.94 95400 MN MINNESOTA $20.68 $9.25 $29.93 $69.11 $9.25 $78.36 97320 PRV PUERTO RICO $14.53 $8.54 $23.08 $48.56 $8.54 $57.11 97350 PRV VIRGIN ISLANDS $22.01 $9.51 $31.52 $73.61 $9.51 $83.12 310200 AZ ARIZONA $21.46 $9.44 $30.90 $71.79 $9.44 $81.23 320201 MT MONTANA $18.56 $9.09 $27.65 $62.08 $9.09 $71.17 330201 ND NORTH DAKOTA $18.13 $8.99 $27.12 $60.61 $8.99 $69.60 340202 SD SOUTH DAKOTA $18.30 $8.99 $27.30 $61.18 $8.99 $70.17 350209 UT UTAH $20.21 $9.28 $29.50 $67.60 $9.28 $76.88 360221 WY WYOMING $18.84 $9.14 $27.98 $63.02 $9.14 $72.16 513000 ID IDAHO $18.64 $9.05 $27.68 $62.29 $9.05 $71.34 544035 TN TENNESSEE $19.02 $9.11 $28.13 $63.58 $9.11 $72.69 553500 NC NORTH CAROLINA $19.84 $9.21 $29.04 $66.32 $9.21 $75.52 1433004 NY3 QUEENS, NY $27.69 $10.45 $38.14 $92.64 $10.45 $103.09 3114003 CA1 MARIN/NAPA/SOLANO, CA $27.34 $10.27 $37.61 $91.37 $10.27 $101.64 3114005 CA1 SAN FRANCISCO, CA $31.16 $10.87 $42.03 $104.12 $10.87 $115.00 3114006 CA1 SAN MATEO, CA $30.97 $10.94 $41.91 $103.48 $10.94 $114.42 3114007 CA1 OAKLAND/BERKELEY, CA $27.86 $10.46 $38.32 $93.10 $10.46 $103.56 3114009 CA1 SANTA CLARA, CA $29.57 $10.85 $40.42 $98.80 $10.85 $109.65 3114099 CA1 REST OF CALIFORNIA* $22.52 $9.56 $32.08 $75.29 $9.56 $84.85 3114203 ME SOUTHERN MAINE $21.65 $9.40 $31.05 $72.38 $9.40 $81.77 3114299 ME REST OF MAINE $19.01 $9.10 $28.11 $63.54 $9.10 $72.64 3114301 MA METROPOLITAN BOSTON $27.96 $10.35 $38.31 $93.48 $10.35 $103.83 3114399 MA REST OF MASSACHUSETTS $23.82 $9.73 $33.56 $79.66 $9.73 $89.39 3114440 NH NEW HAMPSHIRE $22.19 $9.48 $31.67 $74.19 $9.48 $83.68 3114550 VT VERMONT $20.65 $9.28 $29.92 $69.01 $9.28 $78.29 3114617 CA2 VENTURA, CA $26.11 $10.12 $36.23 $87.30 $10.12 $97.42 3114618 CA2 LOS ANGELES, CA $25.72 $10.19 $35.91 $86.00 $10.19 $96.19 3114626 CA2 ANAHEIM/SANTA ANA, CA $26.98 $10.29 $37.27 $90.20 $10.29 $100.48 3114699 CA2 REST OF CALIFORNIA $22.52 $9.56 $32.08 $75.29 $9.56 $84.85