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CPT Codes, Billing & Reimbursement

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  • access_time 11:00 - 11:30 AM CT
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Reimbursement for patient-specific anatomic models and guides has long been bundled into general hospital costs for reimbursement from third-party payers (insurance companies, Medicare, etc.). With the introduction of four AMA Category III CPT Codes in July 2019, a more direct pathway for reimbursement is moving toward becoming a reality. This presentation will discuss reimbursement generally, the Category III CPT codes for anatomic models/guides, who can appropriately use these pathways and "pearls" for implementation of these new billing tools from a hospital standpoint.

Learning Objectives:

  • Describe the current reimbursement landscape with regard to the AMA Category III CPT Codes established
  • Understand some of the moving parts toward implementation of these codes in a hospital environment
  • Describe some of the next steps relating to the path for further reimbursement for anatomic models/guides