Through its ongoing review of potentially misvalued services, the AMA RUC in 2019 flagged EP ablation services for scrutiny because of significant growth in volume. RUC Recommendations From Resurvey Service In 2023, some values could go up slightly and others down slightly from what CMS finalized for 2022 if data from the second survey and recommendations are adopted. Information from the resurvey generally aligned with the first survey in showing large reductions in time. The agency also indicated additional changes could be made for 2023 based on information from the resurvey, which was not incorporated into 2022 rates. While additional survey information was available from a resurvey for the April 2021 American Medical Association RVU Update Committee (RUC) meeting to check the accuracy of the January 2021 surveys, CMS finalized its proposal to maintain the current work RVUs of SVT code 93653 and AF code 93656, while discounting the work of the bundled components for 2022. However, the final rule made no changes to the original proposal. The ACC also submitted formal written comments explaining information from a second work RVU survey and recommending a phase-in of reductions. The ACC and Heart Rhythm Society (HRS) staff and member leaders met multiple times with various agency officials and members of Congress to share information, questions and concerns on the physician fee schedule to ensure work RVU recommendations were clearly understood and informed by the best available information. These reductions essentially eliminate separate payment for 3D mapping, left-atrial pacing, and intracardiac echocardiography (ICE) when performed with supraventricular tachycardia (SVT) ablation and atrial fibrillation (AFib) ablation, as shown in the table below. As part of the 2022 Medicare Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services (CMS) implemented reductions to work relative value units (RVUs) for electrophysiology (EP) ablation services without any modifications.
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