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Notification of Reimbursement Policy Revisions Effective February 1, 2025 (Posted December 1, 2024)

Reimbursement PolicyRevision
Bundling Guidelines Notification

Added 3D radiology bundling rules for facility and professional services. RPOC Approved. Notification on 12/1/24 for effective date 2/01/25

Facility Billing Guidelines Notification

PTA and OTA Modifier CO and CQ reimbursement reduction added. Notification on 12/01/2024 for effective date 02/01/25

Pricing and Adjudication Principles Notification

Postpay medical record request technical denial language added. RPOC approved. Added coding accuracy in guidelines section. Notification on 12/01/2024 for effective date 2/01/2025.

Radiation Therapy Services Notification

Maximum units and frequency language updated throughout policy. RPOC approved. Notification on 12/01/2024 for effective date 2/01/2025.