Ft. Worth, Texas (PressExposure) March 08, 2011 -- As of April 1 of 2010, many physicians were dealt a blow to their pocketbooks, and the clinical efficacy of their practice, when they learned drug screens (done for confirmatory testing of prescribed medicines and/or screens against illicit substances) would no longer be reimbursed by CMS (Center for Medicare/Medicaid Services) at the customary rates. Physicians shied away from drug testing due to this uncertainty, and ultimately some practices dropped testing all together.
Medicare/Medicaid changed CPT code 80101, and ultimately deleted it from the clinical fee schedule (the bible for physician payments from insurance companies as well as Medicare/Medicaid) leaving physicians questioning not only how they would be paid for this testing, but how MUCH they would be paid. CMS instituted CPT code 80104 for private insurers, and G0434 for CMS payments.
Metrix BioMed, a Texas based distributor of in vitro diagnostic devices, whose tagline is "The Physician Office Lab Experts" quickly stepped in to explain the proper coding. Charlie Balentine, VP of Sales and Marketing at Metrix BioMed, initially declined to comment but ultimately gave a brief statement. "While fee schedules and payments are ultimately a very private matter to physician offices, it is important for these business owners to know that the solutions for billing these tests are not only viable and profitable for the practices, but also take an immense strain off of both private insurance and medicare/medicaid by giving a lab-accurate result at a fraction of the cost to payers, and at the same time keeping revenue inside the practitioner's office," said Balentine. "Additionally, Balentine added "It's also great to see practitioners recognizing a significant opportunity to verify, for example, an expectant mother is not on illicit substances, or an elderly patient is compliant with taking their pain medications."
A variety and ever expanding number of practitioners are gravitating towards rapid drug testing in the physician office setting to have all necessary information when making a diagnosis, intervention if necessary, and confirmatory testing.