Medicare Fee Schedule 2012: Train Eyes on Potential Imaging Fee Cuts

James Smith
January 10, 2012 — 1,218 views  
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CMS released its proposed MPFS for the coming year on July 1 this year.

The Centers for Medicare & Medicaid Services (CMS) payment proposals for the coming year indicate the situation could get all the more challenging. Here's a proposed fee schedule update you need to be aware of. 

Train eyes on potential imaging fee cuts

A couple of months back, CMS released its proposed Medicare Physician Fee Schedule (MPFS) for the coming year. The 621-page document provides you insight on how the agency configures its relative value unit (RVU) assignments.

If the proposed rule becomes final, imaging pay will see more cuts. Presently, when you carry out multiple radiological procedures on the Multiple Procedure Payment Reduction (MPPR) list during a single session, Medicare brings down the technical component (TC) of the lower paid procedure(s) by half. However, the agency wants to bring down those payments further.

In the coming year, the agency is laying down that it will not only cut the TC of subsequent radiological procedures by 50 percent, but will also slash the PC by half. Total payment would be made for the PC and TC of the highest procedure, and payment would be brought down by 50 percent for the PC and TC for each additional procedure provided to the same patient in the same session. It also points to the fact that payment cuts to radiology procedures could be even more in two years from now, and beyond that.

Professional societies were critical of the agency's radiology cuts. The American Medical Association (AMA) vehemently opposes a proposal to use major cuts to Medicare payments for diagnostic imaging to pay off the cost of a trade agreement. Diagnostic imaging specifically has already seen significant reductions over the last five years. In fact, payments for some services have gone down over 60 percent and more cuts are likely to take place.

What's more, a lot of radiologists have laid down that multiple interpretations of exams carried out on one patient are not less work-intensive than multiple interpretations of different patients. The time, intensity and mental effort it takes to interpret an individual exam is relatively constant irrespective of whether the patients' exams are interpreted separately or at the same session. Medicare should make an effort to support such quality care and not try to weaken it repeatedly.

For more information on fee schedule for Medicare , sign up for a good coding resource like SuperCoder. Such a site comes with a Fee schedule tool to help you work faster and boost payments!


James Smith

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