CMS delays, reduces proposed Medicare imaging cuts

Nov 3, 2005

The U.S. government's proposal to cut Medicare technical reimbursement for contiguous imaging in both the hospital outpatient and physician office settings has been scaled back or delayed, with the American College of Radiology (ACR) taking credit for the turnabout.

One proposal -- to cut reimbursement by 50% for the additional CT and MR images of contiguous body parts obtained in a single imaging session -- was left out of the final 2006 Hospital Outpatient Prospective Payment System (HOPPS) rule published this week by the Centers for Medicare and Medicaid Services (CMS).

The ACR noted the exclusion and took credit for it in a press release, saying it was the result of "vigorous ACR education efforts."

The hospital outpatient proposal may yet resurface. "CMS officials indicated they would perform additional analyses of relevant data during the coming year to determine what, if any, changes would be appropriate to allow for more accurate payments for diagnostic imaging services," the ACR noted.

"Agency officials said they would look to organizations such as the ACR for additional information and input on future editions of the rule," the ACR continued.

The ACR also took credit for mitigating a similar proposal affecting the technical reimbursement for office-based imaging.

According to the college, Medicare will cut the reimbursement on subsequent MR, CT, and ultrasound imaging of contiguous body areas by 25% in 2006, rather than 50% as originally proposed.

But even that victory appears short-lived, as Medicare apparently plans to phase in the 50% reduction in 2007. The ACR stated that it will continue to oppose the 25% reduction and the planned 50% reduction, and requested that CMS delay its plans for one year for further analysis.

CMS described its decision on the office-based imaging reimbursement cuts and the comments it received on the proposal beginning on page 577 of this week's 1,218-page final rule for the 2006 Physician Fee Schedule.

By Tracie L. Thompson
By AuntMinnie.com staff writer
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