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BILLING FOR USE

Posted: Wed Feb 03, 2021 9:35 am
by lisa_giansanti
Are users billing for each use of SGRT or only for motion management or IGRT. Our therapists prefer to use AlignRT for all breasts. The insurance companies, however, are not reimbursing for right-sided breast cases. There is discussion as to whether it is ok to use the AlignRT for set-up on right-sided cases without charging if we are charging for our DIBH patients.

Please let me know how you practice!

Re: BILLING FOR USE

Posted: Thu Feb 04, 2021 10:18 am
by The SGRT Community

We assume this question is related to use of AlignRT with IMRT. SGRT/AlignRT may be reported when medically indicated for patient treatment. Documentation in the patient’s record must indicate the medical necessity of the use of the technology. Some payers will limit the use of IMRT within the payer’s policy, and this requires the providers to be aware of the policy for each patient’s plan. When plans limit the use of IMRT to right breast, IGRT is also limited. There is nothing to prevent you from providing a service without charging. Should providers have specific question about policy limitations, you are welcome to reach the reimbursement support team at VisionRT@thepinnaclehealthgroup.com.

Re: BILLING FOR USE

Posted: Fri Feb 05, 2021 8:22 pm
by lisa_giansanti
Thank you!