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4 Ways to Take Control Of Your Pain Management Service
Maximizing the reimbursement potential of your facility.
Amy Mowles
Publish Date: June 9, 2008   |  Tags:   Pain Management
Now that CMS has revamped its pain-management procedural codes and awarded pain management physicians a specialty designation, it's a propitious time to either add or expand your pain management services. But managers who are not familiar with this continually growing field should be aware that pain management is a little different than some of the other services surgical facilities offer. Because chronic pain is somewhat vaguely defined and because the management of this disease is an evolving and often poorly understood discipline, regulators have scrutinized this field closely and penalized some providers harshly. Pain management is an excellent opportunity to help patients and increase your profits, but only if you are committed to strictly adhering to the fundamentals and watching your Ps and Qs. With that in mind, here are a few pointers.

Understand the changes
Until recently, CMS did not officially recognize pain management as a specialty. Due to the lack of a specialty designation, the agency did not have a way to track actual practice expense. Most pain management procedures were calculated using anesthesia practice expense; a very low rate of reimbursement.

As of January 1, 2002, the agency now recognizes pain management as a specialty. Physicians who do a lot of chronic pain management (50 percent or more is a good guideline) need to complete an 855 form and select specialty code 72. This will assist in evaluating true practice expenses for physicians practicing pain management and help make the case that pain management specialists should sit on Medicare carrier's boards.