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But Medicare has now introduced a special reimbursement code just for the smaller doses of Avastin.
On Tuesday, the government will also establish a reimbursement code allowing doctors to identify themselves as specialists in pain management.
The Medicare reimbursement code will encourage doctors to provide such treatment to patients with cancer, arthritis, sickle cell anemia, AIDS and other diseases that cause severe pain.
In contrast, the reimbursement code for electronic prescriptions is used only for prescriptions.
Often what has passed for innovation in healthcare is a clever way to maximize the latest reimbursement code or government incentive.
The reimbursement code used for claims related to paper prescriptions is sometimes also used for other services (long-term sickness leave certificates and requisitions for physical therapy).
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For readers worried about potential out-of-pocket costs for vitamin D tests — they range from $40 to $225 — he listed the precise reimbursement codes that doctors should use when requesting insurance coverage.
But starting next month, under new reimbursement codes proposed by the American Medical Association, the planning sessions will be covered by Medicare no matter when patients want to have them.
The Centers for Medicaid and Medicare Services (CMS) have created new reimbursement codes covering chronic care and outpatient transition, and developed pilot programs that offer incentive payments for comprehensive diabetes care, among other things.
Some of the Trump administration's decisions, like requiring separate reimbursement codes for "biosimilar" competitors to branded biotech drugs, will actually create incentive for higher, not lower, drug prices.
The size of the price cut is also unclear, although LeCroy estimates it could drop by 70-80% now that Medicare plans to give Xoponex the same reimbursement codes as other forms of albuterol, a generic drug.
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