ASTRO would like to remind members of the guidelines for billing for repetitive services, such as brachytherapy, in the hospital setting. CMS guidance addresses billing frequency for outpatient services but does not specifically address services packaged within a comprehensive ambulatory payment classification (C-APC). It does state that repetitive Part B outpatient services for a single patient should generally be billed monthly or at the end of a treatment course, including radiation therapy services, although expectations within the C-APC structure remain less clearly defined. ASTRO has engaged the Agency regarding codes that are part of the C-APC methodology (e.g., brachytherapy), and CMS has indicated that services delivered over multiple patient encounters can be reported per encounter.

Revenue codes usually reported for chemotherapy and radiation therapy are not on the list of revenue codes that may only be billed monthly. Therefore, hospitals may bill chemotherapy or radiation therapy sessions on separate claims for each date of service.  
 
However, because it is common for these services to be furnished in multiple encounters that occur over several weeks or over the course of a month, hospitals have the option of reporting charges for those recurring services on a single bill, as though they were repetitive services. If hospitals elect to report charges for recurring, non-repetitive services (such as chemotherapy or radiation therapy) on a single bill, they must also report all charges for services and supplies associated with the recurring service on the same bill.  

For additional coding information, please refer to ASTRO’s Coding Resource.