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Physician Regulatory Issues Team (PRIT)

Past PRIT Issues


  Details for How to bill for multiple endoscopy procedures
  

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Issue Name How to bill for multiple endoscopy procedures
Issue Some physicians were unsure how to bill for multiple endoscopy procedures.
Status Payment for a 3rd (or more) related endoscopy procedures in the same operative session, performed on the same patient by the same physician would be priced according to the multiple endoscopy rule (MCM 15038). This rule states that Medicare pays the full value of the highest valued endoscopy procedure, plus the difference between the next highest value and the base rate.
Date Issue Created 01/01/2003

 


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Last Modified Date : 05/10/2006
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