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Yet payers don't reimburse robot-assisted surgery at a higher rate. At
one time, plans covered robotic surgery with an add-on code, but that
changed about 7 years ago, says Julie Kessel, MD, senior medical
director for coverage policies at Cigna. "We decided that because the
robotic approach was now a widely accepted standard in surgery, we
would no longer consider separate reimbursement for it," she says.
"We came to consider the robotic assist integral to the surgery itself," a
determination she says is typical among commercial payers. Medicare
employs a similar reimbursement policy: no premium for robotic
assist, says Ms. Webb.
Hospitals have an internal conflict when it comes to embracing same-
day robot-assisted surgery. "Hospitals are incentivized to bill out the
highest level of care while getting the patient out the door as quickly as
possible," says Ms. Webb. For hospitals, the highest level of care
includes an overnight admission. OSM
Mr. Kirkner (
rmk irk ner@verizon.net
) is an independent healthcare journal-
ist. Kendal Gapinski contributed to this report.
U R O L O G Y
