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CMS-1403-FC
jeopardizes beneficiary access to care. One commenter
indicated that we should examine any shifts in the
site-of-service that may have resulted due to the MPPR.
Response: The Government Accountability Office (GAO)
and the Office of the Inspector General (OIG) have been
performing several reviews relating to the utilization of
imaging procedures, including the effects of the OPPS cap
and the MPPR on utilization, payment, and access to care.
We will continue to monitor the effects of the policies to
ensure that beneficiaries have proper access to care.
After reviewing the public comments, we are proceeding
with the policy as proposed. The ten additional
procedures, listed in Table 6 will be subject to the MPPR,
effective January 1, 2009.
3. HCPCS code for Prostate Saturation Biopsies
In the CY 2009 PFS proposed rule, we proposed to
create four new G codes for prostate saturation biopsy as
shown in Table 7, currently reported with CPT code 88305,
Surgical pathology, gross and microscopic examination,
which is separately billed by the physician for each core
sample taken. We also proposed to have Medicare
contractors price these codes.
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