It is expected that a Comparative Billing Report (CBR) will be released today to providers of certain pain management services as a proactive tool to help prevent improper billing. This report will be released by SafeGuard Services LLC, a Centers for Medicare & Medicaid Services (CMS) contractor. Pain management has been identified as a vulnerability in the Medicare program, which has resulted in CMS’s recommendation that comparative studies be conducted and the results shared with providers of these services as part of ongoing provider education efforts.
The billing data in the CBR is reflective of your practice, illustrating the average number of pain management services you perform per beneficiary, and compares your results with those of others from your specialty and national peers who also bill for these services. You may receive more than one CBR if you bill under more than one specialty designation.
This report does not indicate that a provider improperly billed Medicare for pain management services. Rather, this report is informational and can assist you by allowing you to compare your practice’s billing with that of your colleagues.
The data in the CBR will encompass all Medicare Part B final claims data with dates of service from October 1, 2010 through September 30, 2011 and that meet the criteria listed below:
- Transforaminal epidural injections and paravertebral facet joint injections: CPT® codes equal to 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, and 64495.
- Place of service equal to office (11).
- Provider specialty equal to 05 (Anesthesiology), 09 (Interventional Pain Management), 25 (Physical Medicine and Rehabilitation) and 72 (Pain Management).
- Covered charge amount greater than $0 (data are pulled from claims that were processed, and denied services are not included).
If you have any questions on the CBR content, visit www.cbrservices.com or call (530) 896-7080.