Abstract
Medical physics services in medicine are reimbursed through the Current Procedural Terminology (CPT) Codes published by the American Medical Association in an annual publication. Although CPT codes for medical physics services appear explicitly in the radiation oncology series of CPT codes (77XXX), diagnostic radiological physicists may use several of these codes to cover patient specific work they may be called on to perform. This refresher course will trace the advent of the Centers for Medicare and Medicaid Services (CMS) relative value system for reimbursement for medical services and explain in detail how the complex system operates for current and new technology codes. Payments differ in various settings such as hospital, free‐standing center and ambulatory surgical center and these differences will be traced for each site of service.Additionally, private health insurance carrier are not required to follow the precepts of the CPT formalism and these reimbursement entities will be described in their methodology of reimbursement for these services. Finally, ancillary publications that impinge on these reimbursement rules (eg. Correct Coding Initiative, CCI) will be referenced. Coding compliance guides such as those published by ASTRO and ACR will form the basis for this economics refresher course.
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