NOVO Health has some exciting updates to share with you about the NOVO Health Bundled Payment Program for Health Services!

  • New In-Office MRI/MRA Bundles become available April 1, 2021
    • Starting April 1, 2022, if your employee needs MRI/MRA imaging while being evaluated at the Orthopedic and Sports Institute, NeuroSpine Center of Wisconsin, or Aspen Orthopedics, they can receive the study as a stand-alone bundle, right there in the treating physician’s office.
    • Because not all patients require magnetic resonance imaging (MRI) or magnetic resonance angiography before a bundled procedure, those advanced imaging services are not included in our surgical bundles. Historically, the facility supplying the imaging equipment would bill for the technical component and the radiologist interpreting the study would bill for the professional component, as separate fee-for-service claims.  Now, these services are part of a single bundle with a fixed price.
    • Occasionally, a scan needs to be repeated to obtain a useful image (such as when patient motion creates an artifact in the imaging scan). In the context of these diagnostic bundles, the NOVO Health limited warranty means that if a rescan is needed on a bundled MRI/MRA, there is no additional charge.  No treatment in follow up to the scan is included in the diagnostic bundle.
    • To take advantage of these bundles, an employee must be seeking evaluation or treatment from a physician in the clinic that performs the MRI/MRA imaging. (This is because these clinics are not licensed as independent diagnostic testing facilities and were designed to serve patients treating with their own physicians.)
    • The suggested cash bonus for employees using these bundles is $100, for those companies that take a cash bonus approach to Shared Savings.
    • As with other diagnostic bundles, the per-transaction management fee for these new bundles is $50 per bundle (not the $750 for surgical and procedural bundles). There is no up-front cost to add these bundles to your program.

Below is the corresponding addition to the Non-invasive Diagnostic Bundles Table:

Service Bundle Index Event by CPT-4 Code Service Bundle Specific Inclusions Reimbursement Rate
Magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA) performed as in-office ancillary procedure 72141-42, 72146-49, 72157-59, 72195-98, 73721-23, 73718, 73720-22, 73218, 73220, 73221-23 Includes scans with or without gadolinium contrast; MRI performed with intra-articular contrast is not available in this bundle  

 

 

$1,200
  • We’ve added new providers, bringing you even more access to affordable care
    • Milwaukee Surgical Suites is now an available center of excellence for orthopedic and podiatry procedures.
      • This accredited surgery center is located in Franklin, Wisconsin, about 15 minutes south of Milwaukee.
      • The addition of this center means total knee replacement can now be bundled and performed in the Milwaukee market.
      • To take advantage of this new location, employees should call Care Navigation for priority scheduling at Aspen Orthopedics
    • The following radiology groups have joined this program to provide professional reads as part of our new in-office MRI/MRA bundles:
      • Green Bay Radiology
      • Radiology Associates of the Fox Valley
      • Milwaukee Radiology