FAQs

What is the difference between the Medicare physician fee schedule and the outpatient diabetes center payment?

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Medicare physician payments are fee schedules based on relative value units (RVUs). Hospital outpatient services are paid under the outpatient prospective payment system (OPPS). CPT code 95250 (for Professional CGM only) is paid under Ambulatory Procedure Classification (APC) 5012 with 2017 national average payment of $106.

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