Urodynamic procedures can be scheduled for reimbursements through Medicare and other insurance companies. You will need to know the exact codes listed below in the article to help build a proper case for calculating how much you can be reimbursed for. The following information is a guide to help you estimate your reimbursement. However, not all reimbursements will be accepted. Contact your insurers for an assessment to check if you qualify for urodynamic procedure reimbursements. Each insurance office has strict policies and guidelines on whether you will get accepted or denied your reimbursement.
I recently attended a statewide gastroenterology conference in Mississippi. I got to meet all types of interesting people, including accomplished doctors and their staffs. For this conference I compiled some data on anorectal manometry (ARM) reimbursement rates. Given gastroenterologist use of colonoscopies, I thought it would be useful to compare ARM reimbursements (CPT Codes 91120, 91122, and 51784) to screening colonoscopy reimbursements (CPT Code 45378). I was aware that ARM reimbursed at a better rate, but I was not aware it was substantially better. When looking only at National Medicare reimbursements, anorectal manometry reimburses at a 93% higher rate than a screening colonoscopy. In the chart below you'll see the trend of reimbursements rates both nationally and within the state of Mississippi over the last decade. As you can see, and as every gastroenterologist knows, colonoscopy reimbursement rates have fallen quite significantly and are expected to fall more in coming years. However, ARM shows a more stable reimbursement rate, especially in recent years.