Last week I included a short story about the announcement made by Blue Cross/Blue Shield in Mississippi (BCBS-MS) that it was cutting reimbursement for some pathology services by 25%, effective May 15. A pathologist who practices in Mississippi contacted me to provide some information on what has taken place since the announcement. And I couldn’t help but laugh when I heard some of what he had to tell me.
After the announcement was made, the Mississippi State Medical Association (MSMA) rallied and wrote a letter to the CEO of BCBS-MS making its displeasure with the cuts known. This immediately caught my reader’s attention, as the MSMA had apparently never lifted a finger to help pathology before.
Now remember, the cuts only involve certain radiology and pathology procedures. But in the letter, Dr. Steven Demetropoulos, the MSMA president stated (emphasis added):
I believe that BCBS-MS has proceeded with an unnecessarily heavy hand to make major and financially significant cuts to reimbursement to hundreds of physicians practicing radiology, pathology and other specialties.
To what other specialties is he referring? BCBS-MS only announced cuts to pathology and radiology.
To answer that question, one must remember in-office laboratories and client billing (Mississippi is a client billing state).
From the MS pathologist:
Most of the screamers are the family practice docs and internists who are losing their mark-ups on clinical lab tests. The PC for 88305 went up.
One group of endocrinologists is thinking of eliminating their lab (and sending to the hospital) because they are losing their mark up and profits from running their labs.
One group of GI physicians has complained that the fees paid by BCBS should not be lowered for 88305-TC. I wonder why the GI guys are suddenly interested in our codes?
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