The U.S. Centers for Medicare and Medicaid Services (CMS) said on Tuesday that it will not propose increasing the multiple imaging payment adjustment to 50%, but rather will seek to maintain the adjustment at the 25% level.
The Medicare Physician Fee Schedule (MPFS) proposed rule for 2007 included a proposal to implement two provisions of the Deficit Reduction Act (DRA) of 2005 affecting payment for imaging services under the fee schedule. The first provision addressed payment for certain multiple imaging procedures, with full payment for the first procedure, but a 50% reduction in payment for additional imaging procedures on contiguous body parts during the same session.
The second 2007 proposed rule limits the payment amount under MPFS to the outpatient department payment amount for the technical component of certain imaging services. Under this provision, the physician fee schedule payment amount for certain imaging procedures would not exceed the amount paid to a hospital outpatient department, CMS said.
The agency said that for imaging services subject to both the multiple imaging reduction policy and the outpatient hospital cap, it proposes to first apply the multiple imaging adjustment and then apply the outpatient cap. CMS said that this approach results in higher payments than if the cap were applied first.
By AuntMinnie.com staff writers
August 9, 2006
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Public Citizen makes case against DRA, July 11, 2006
House bill seeks to delay DRA imaging cuts, June 29, 2006
DRA 2005 in practice: Where the rubber meets the road, April 27, 2005
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