- New Category 1 CPT® codes mark the first newly available reimbursable codes for fracture risk assessment in osteoporosis in nearly a decade
- Reimbursement set at $41.53 (Physician Fee Schedule) and $82.61 (Hospital Outpatient Prospective Payment System)
- Effective January 1, 2022, for TBS Osteo™ procedures performed for DXA and X-ray imaging
Geneva, Switzerland — March 4, 2022
Medimaps — the creator of TBS® (Trabecular Bone Score®), the global standard in bone microarchitecture assessment — today announced that CMS reimbursement is now available for TBS Osteo™ for DXA and X-ray imaging.
In 2021, the American Medical Association (AMA) approved dedicated Category 1 CPT® codes for TBS Osteo™ for DXA and X-ray imaging, and CMS approved a reimbursement amount for the codes.
The final CMS ruling lists the reimbursement amount for a TBS® procedure at $41.53 on the Physician Fee Schedule (PFS), and $82.61 under the Hospital Outpatient Prospective Payment System (OPPS).
The reimbursement and Category 1 CPT code were submitted to the AMA and CMS by the American College of Radiology®, and supported by rheumatology and endocrinology societies.
"Reimbursement through CMS is an important endorsement of the clinical value of TBS® for clinicians and their patients. Currently, more than 600,000 TBS® procedures are performed in the US annually. As more doctors understand how TBS® can enhance their ability to better predict a patient's risk of bone fracture, we anticipate this will further establish TBS® as a standard of care."
said Prof. Didier Hans, CEO of Medimaps.
Osteoporosis is a condition of primary concern among an aging patient population. Patients at risk for osteoporotic fractures often receive a bone mineral density (BMD) assessment, which measures the quantity of bone but not its quality.
TBS Osteo™ works alongside BMD to analyze bone microarchitecture as an assessment of bone quality, providing practitioners with an easy-to-interpret score to quickly identify and classify patients’ fracture risk and guide a course of intervention.
The technology uses the same images already acquired for BMD or X-ray assessment, integrating seamlessly into a physician’s clinical workflow without exposing patients to additional radiation or acquisition time.
Medimaps’ proprietary and patented technology is built on a deep learning, multi-layer approach applicable across a wide spectrum of image modalities and resolutions — supporting solutions ranging from opportunistic X-ray-based screening to patient risk profiling and presurgical assessment.