Reimbursement is always a hot topic in urologic care, especially with regards to specific procedures. While individual payors may vary with regards to what they pay for specific evaluation and management (E&M) and procedures (CPT codes), almost all reimbursement is ultimately driven by what rates Medicare will pay and/or how many Relative Value Units (RVU’s) Medicare will assign to a specific E&M or CPT code. This post will review reimbursement trends for urodynamics in 2020 (UDS).
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.
Urodynamics is performed by thousands of medical practices across the country, but is most often performed by urology, urogynecology, and ObGyn practices. BHN provides urodynamics testing to hundreds of these practices, and through our work we encounter dozens of instances in which Urodynamics is billed incorrectly, which often leads to underpayment and other issues.