Complete Story
10/21/2016
BWC Announces 2017 Reimbursement Plans
Two new orthopedic procedures to be added.
The Ohio BWC has announced to the OAASC their plans for ASC reimbursement rates for 2017.
In discussions with the OAASC, the BWC said that it will discuss with BWC Board of Directors a total package that includes:
- Adopting the 2017 ASC PPS rates as published in the CMS rule (proposed) which includes a 1.2% payment increase (as proposed)
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Maintain current BWC payment adjustment factors:
- 112% above Medicare for designated orthopedic procedures
- 110% above Medicare designated pain management procedures
- 100% of Medicare all other allowed procedures
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Addition of two additional arthroplasty procedures for BWC-certified ASC Arthroplasty Centers that are currently only performed in an in-patient hospital setting
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27130 Arthroplasty, acetabular and proximal femoral prosthetic, with or without autograft or allograft
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27447 Arthroplasty, knee, condoyle and plateau; medial AND lateral compartments with or without patella resurfacing
- Both new procedures would be reimbursed at $7877.00
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Estimated 2017 reimbursement is $5,588,768 which is a 4.4% increase from 2016 estimated reimbursement
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Impact on key service areas for Ohio ASCs
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Orthopedics +5.6%
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Pain management +0.2%
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All other services +3.0%
It is encouraging that the BWC is interested in expanding services in areas that are currently not covered, especially in the BWC high volume orthopedic area. However, the level of reimbursements would often barely cover the implant costs, which are included. We will be making the ASC case to readdress these reimbursements.
Additionally, the Ohio BWC will be holding an ASC summit to address the ongoing expansion and reimbursement issues for ASCs as a part of the workers compensation system. This meeting will be held on November 29 (new date from 11/1) in the Columbus area. OAASC members interested in being a part of this meeting should contact Randy Leffler at rleffler@oaasc.net
