Reimbursement

The ASTS educates and advocates the Centers for Medicare and Medicaid Services (CMS) concerning coverage decisions for organ systems and immunosuppressive drugs, the Physician Fee Schedule (PFS), the Inpatient Prospective Payment System (IPPS) which includes changes to the Diagnosis Related Groups (DRGs) and other reimbursement issues that impact ASTS members.  The ASTS works with the American Medical Association and the American College of Surgeons through its Relative Value Update Committee (RUC) process to recommend new Coding Procedural Terminology (CPT) and update relative values for CPT codes. The ASTS Council, Committees and Special Task Forces work with reimbursement counsel to provide education and recommendations.

CMS Center for Medicare and Medicaid Innovation (CMMI)

Use the following link, http://innovations.cms.gov/  to access the CMS Center for Medicare and Medicaid Innovation (CMMI) website. The website serves as the primary vehicle for submissions of proposed projects and information and updates on the CMMI process. CMMI is focused on three priorities for innovative ideas: 1) Patient Care Models, 2) Seamless and Coordinated Care Models, and 3) Community and Population Health Models.

Physician Quality Reporting System (PQRS) Resources 
2012 PQRS Primer prepared by the ASTS Standards Committee
2012 PQRS Internal Billing Form Example prepared by the ASTS Standards Commitee 

2012 PQRS information provided by the Centers for Medicare & Medicaid Services (CMS)

Reimbursement Archives