MAUI, HAWAII — The Centers for Medicare and Medicaid Services' decision to reimburse for total body photography as a screening tool for early melanoma in high-risk patients is good and bad news, according to Dr. Allan C. Halpern, chief of the dermatology service at Memorial Sloan-Kettering Cancer Center, New York.
The good news is that reimbursement for this clinically important technique will become far more widely available. And the bad news?
“Unfortunately, based on the Relative Value Units involved, [total body photography is] going to be reimbursed at about $70-$80. Until now, most third-party payers haven't covered total body photography, but of the one-third to one-half who have, they've paid $125-$350.”
That reimbursement rate is likely to come down in response to the CMS decision, Dr. Halpern predicted at the annual Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation.
Another potential pitfall with broader medicare reimbursement is that patient compliance with return visits for follow-up images may drop, Dr. Halpern added at the meeting.
“A lot of patients now pay out of pocket for total body photography, so compliance with follow-up visits is pretty high. My guess is that with wider reimbursement and greater use, compliance may not be as high. So it's important not to raise your threshold for excision on the first visit because you expect to see the patient again with baseline photos for comparison,” the dermatologist cautioned.
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