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SNM contests proposed CMS payment rules By AuntMinnie.com staff writers November 6, 2009
Nuclear medicine society SNM has raised significant concerns about proposed reimbursement rules for imaging procedures, announced by the U.S. Centers for Medicare and Medicaid Services (CMS) on October 30.
As with other medical professional groups, SNM noted that the rates could pose particular problems, especially if Congress does not lift implementation of the sustainable growth rate (SGR) formula slated to reduce across-the-board payments by 21.5% beginning in January 2010. Congressional legislation is currently in process to repeal the SGR.
The Reston, VA-based SNM drew attention to two specific negative impacts that pertain to reimbursement rates for nuclear medicine procedures.
In 2010, CMS moves to a four-year transition period to implement results of the American Medical Association's Physician Practice Information Survey (PPIS). However, the SNM questions basic assumptions made in the PPIS and asserts that the survey data do not accurately represent actual practice expenses for nuclear medicine.
The second issue relates to a major reduction in payment for SPECT myocardial perfusion imaging scans. In most instances, wall-motion and ejection-fraction codes were added to the perfusion studies so often that CMS decided they should be bundled into a single code. In addition, CMS treats the newly-bundled codes as "new or significantly revised," so a full rate reduction would be applied for 2010 rather than being phased in over time.
Currently, SNM is further analyzing the impact of the changes and formulating a response to CMS.
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