We received the following letter from Humana, dated June 1, 2011:
"Dear Physician or Administrator:
In accordance withe the Modification of Agreement provision in our existing Humana and ChoiceCare Network agreements, we are providing you with notice of intent to make changes to your current commercial Payment Attachment. This will not affect your current Medicare Advantage reimbursement. The details of the changes are listed below. Unless you object in writing within the next 90 days, these changes will become effective September 1, 2011.
What are the changes?
Reimbursement for radiology services will be paid at one hundred percent (100%) of the Humana and ChoiceCare Network 079-755 fee schedule. Humana and ChoiceCare's 079-755 radiology fee schedule reimburses for MRI, CT and PET Current Procedural Terminology (CPT) codes at seventy-three percent (73%) of 2006 Ohio Medicare fee schedules and payment systems, Screening/Diagnostic mammogram Current Procedural Terminology (CPT) codes at one hundred and thirty percent (130%) of 2006 Ohio Medicare fee schedules and payment systems, and all other diagnostic radiology services at one hundred percent (100%) of 2006 Ohio Medicare fee schedules and payment systems.
Explanation of fee schedule.
Humana and ChoiceCare's (079-755) fee schedule is based on the 2006 Ohio Medicare fee schedules and payment systems, including the site-of-service payment differential. Additionally, Humana will adjust the schedule to include and assign fees for services which are not covered by RBRVS. A list of those Humana adjusted codes and fees will be available to Physician upon request.
If you wish to object to the Humana and ChoiceCare Network reimbursement changes, please send written notification to the following address:
Humana/ChoiceCare Network
Attn: Contracting Department
640 Eden Park Drive
Cincinnati, OH 45202"