Amendments for services rendered or of NY
(Page 30 of the pdf)
The application of the New Jersey fee schedule has been a complete scourge on the no-fault system. As I have said repeatedly, when a problem becomes redundant and problematic, DFS will after a 3-4 year period address the issue through regulatory amendment. $20,000 arthroscopes in New Jersey fit this definition. It appears this will take in effect in November.
In essence, a surgeon can bill can no greater than Region IV or the New Jersey ASC. A facility will only be able to bill the lower of the most expensive EAPG rate (used to be PAS) or the New Jersey ASC for services. Exceptions are made for emergency care and a person who resides in New Jersey – not bused from Bronx to Saddlebrook, Jersey City or Englewood Cliffs by Square Circle Synagogue Transportation (the old timers will get this reference).
This regulation of course deals with all services rendered outside of NY; I stress New Jersey because that was the impetus behind the regulation.
FYI – The newer issue we are now seeing is the application of the 20999 BR surgery code since surgeons do not want to be subject to the 50% multiple procedure reduction or the true RVUs of the procedure that is billed. This can triple a surgeon’s bill. One problems solved, one problem created.
6 Responses
We are locked out bro.
Try again. Wrong URL. Running a blog is not easy work.
Under No Fault a surgeon gets almost nothing for surgery.
That’s great for patients.
This whole goddamn thing is fucking unbelievable. So Fascist. So Communist.. We are forced to have No Fault. If we get hurt in a car accident we cannot use our own health insurance because it is secondary. So No Fault forces inferior doctors on us.
we are forced to get low paid miscreants to do our surgery because they are the only surgeons that will accept no fault.
You are a depraved Ner Do Well Jason that should do well because you are in a sick Nation of losers.
Not even a pithy response Jason. Where is the Jason I know and love.
You complete reprobate.
Some Jason lover please stick up for him
Love is in the air Ray. You and jason. we cant blame this reg on jason though. lets pile on your president trump instead?
President Trump has nothing to do with No Fault.
He would probably believe as I do. Abolish it.