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Question:
How does CMS account for radiopharmaceutical payment if it falls under indicator “N”?
Answer:
For diagnostic radiopharmaceuticals with status indicator “N,” CMS bundles the cost into the procedure payment rate. CMS and medical specialty societies strongly encourage facilities to code and bill separately for radiopharmaceuticals regardless of their status indicator. CMS also states, “All these charges play a role in defining future hospital payment.”
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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