2016 | HFSA

CMS Approves new HF Specialty Designation Code

Practice News Patient Resource

After great effort by HFSA and ACC, CMS this week informed the societies that it has approved a new specialty designation code for “Advanced Heart Failure and Transplant Cardiology.” The new designation will allow CMS to distinguish a HF/transplant cardiologist from a clinical cardiologist when billing for Medicare services. Previously no mechanism existed for CMS to accurately identify this category of physician for quality and payment programs. Some local Medicare carriers have denied claims in the past, citing duplicate billing, when a cardiologist and a HF specialist from the same group practice have billed for patient evaluation services. Once CMS takes necessary steps to create the new code—which can take up to a year or more —it will allow for the reporting of the involvement of two specialty physicians providing distinct services to an individual patient. HFSA and ACC are requesting that CMS expedite the process to allow for payment. Stay tuned for additional information.