Regulatory Affairs

5) Why did CMS delete C1300?

As part of the AMA RUC process, the evaluation of 99183 resulted in a review of the DIRECT practice expense that is incurred by physicians providing hyperbaric oxygen therapy in a non-hospital based setting. The last time this was addressed was in 2004/2005 by CMS, and the inputs were not validated by the AMA RUC process. In that assessment, the value of oxygen for an ENTIRE monoplace hyperbaric oxygen treatment was $0.54. Air utilization was valued at $4.68 for air breaks. After rigorous debate at the AMA RUC meeting, revised direct practice expense inputs were recommended.

Interested stakeholders had been meeting with CMS to discuss the issue of physician supervision and the inequality of “practice expense” when compared to hospital based reimbursement. When CMS looked at the RUC recommendation, and took stakeholders comments concerning the discrepancy into consideration, they chose to create a code, G0277, which can be billed across all places of service.