Frequently Asked Questions
 
Q With decreased reimbursement for mammography in general, how can outpatient care facilities justify investing in CAD?
A

From the patients point of view, catching one cancer that would otherwise have been missed or catching one cancer a whole year earlier more than justifies the cost of a Computer Aided Detection (CAD) system.

CAD has become an accepted standard of care and we believe that facilities not offering CAD may start losing patient volume, since our install sites tell us that patients are often attracted to their site because they offer digital mammography and CAD..

Even with CAD dropping in 2008, it still does not take long to justify the cost of the CAD purchase. As an example, a site screens 4 patients an hour, 5 days a week, and 200 days a year equals 4,000 patients a year. Reimbursement in an Outpatient center for mammography CAD in 2007 is $14.02 per patient. That’s $56,080 a year that the center would not have received if it hadn’t done CAD, plus the additional cost of doing two independent reads versus the cost of CAD. This all translates to better patient care, reduced costs, and the ability to break even in less than a year. The 2007 Medicare, national payment averages are shown below.

2007 Medicare Part B Physician Fee Schedule

National Averages For Mammography Services Provided in Freestanding Imaging Centers and Physicians’ Offices

2006 CPT Code

2007 CPT Code

Description

National Payment Average

2006

2007

76082

77052

Computer aided detection, diagnostic

19.71

17.43

 

 

Technical Component

16.30

14.02

 

 

Professional Fee

3.41

3.41

76083

77051

Computer aided detection, screening

19.71

17.43

 

 

Technical Component

16.30

14.02

 

 

Professional Fee

3.41

3.41

2007 Medicare HOPPS Fee Schedule

National Averages For Mammography Services Provided in Hospital Outpatient Departments (Covers Technical Component Due to Hospital Only)

2006 CPT Code

2007 CPT Code

Description

National Payment Average

2006

2007

76082

77052

Computer aided detection, diagnostic

16.30

14.02

76083

77051

Computer aided detection, screening

16.30

14.02


   

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