Medicare moves to pay for stroke thrombolytic therapy

Hospitals will no longer lose money for thrombolizing stroke patients with tissue plasminogen activator (tPA).

In midsummer, the Centers for Medicare and Medicaid Services unveiled DRG 559, a new code that pays $11,578 per case of acute ischemic stroke treated with a thrombolytic. Hospitals had previously been paid a flat rate of about $4000 to $6000 per case, regardless of whether thrombolytics were used.

"We have been barely breaking even for some time here," said Dr. Kieran Murphy, director of interventional neuroradiology at Johns Hopkins University. "Even though we have an excellent program in place that allows us to treat these patients appropriately, we've had to be very cautious, trying to lose as little money as possible."