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There are at least two current procedural terminology (CPT) codes (99429 and 99499) for which

These services would not be subject to the minimum payment standard set in the rule because there are no RVUs and there is no conversion factor associated with them. Therefore, a Medicare-like rate cannot be developed. The state may continue to reimburse them at the current Medicaid rate but enhanced federal financial participation (FFP) will not be available for those services.

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This FAQ was released as part of a larger set. View the full set. (PDF, 25.85 KB)

Date

Thu, 02/28/2013 - 12:00

Topic

Affordable Care Act

Sub Topic

Final Rule

Provider Payments

FAQ ID

93881

FAQ Page

Frequently Asked Questions

FAQ Question

There are at least two current procedural terminology (CPT) codes (99429 and 99499) for which there are no relative value units (RVU) and the state manually prices the services for purposes of Medicaid payment. Will CMS develop a Medicare-like rate for these codes under the CMS 2370-F rule?