Highmark Medicare reduces reimbursements for CV outpatient telemetry services

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon

Highmark Medicare Services implemented a reduced reimbursement rate for outpatient cardiovascular telemetry, as of Sept. 1.

The rate, $754 per service, represents a 33 percent reduction from the $1,123 reimbursement rate which HMS had just published in May.

Conshohocken, Pa.-based CardioNet, a provider of ambulatory, outpatient monitoring solutions, said communications from HMS in April indicated there was no pending change. However, on July 10, CardioNet said it received written notice of the planned decrease. According to CardioNet, HMS provided no advance opportunity for dialogue related to this change.

In its most recent communication to CardioNet, HMS stated that CardioNet can provide “additional information and that HMS would review it within a reasonable time and further adjustment to the allowance would be made, if appropriate.” In response, CardioNet said it intends to pursue this approach, as well as work with the Centers for Medicare & Medicaid Services to arrive at a higher level of reimbursement.

Mobile cardiac telemetry technology has now been used in over 300,000 patients nationwide, according to Randy Thurman, chairman, president and CEO and CardioNet. In addition, the company has spent millions of dollars developing and building the infrastructure for this technology.