CMS Reclassifies EVAR and Improves Reimbursement
August 3, 2015—The Centers for Medicare & Medicaid Services (CMS) reclassification of endovascular abdominal aneurysm repair (EVAR) to a new Medicare Severity Diagnosis-Related Group (MS-DRG) classification will result in increased hospital reimbursement for these procedures. CMS released its final rule for fiscal year 2016 policies for inpatient payments on July 31st. The reclassification is effective October 1, 2015.
CMS is deleting MS-DRGs 237 and 238 (Major Cardiovascular Procedures) and creating five new MS-DRGs that separate 13 aortic and heart assist procedures from other less invasive and less costly procedures. MS-DRGs 268 and 269 will include open and endovascular abdominal aortic aneurysm repair procedures. Compared to the current MS-DRG assignments, the payments for these two new MS-DRGs will result in an aggregate increase of 9.1% in inpatient payments.
For EVAR, the reimbursement base rate for noncomplex procedures under the new classification will provide an approximate 15% increase in payment, and complex cases will receive an approximate 24% increase in payment.