New tool estimates prices for breast cancer screening

The Harvey L. Neiman Health Policy Institute has developed a free resource that allows radiology practices to estimate professional, technical, and global bundled prices for breast cancer screening.

The Breast Screening Bundle Tool uses different assumptions depending on which services are included, as well as service utilization and reimbursement rates. It was presented this week at the American College of Radiology (ACR) annual meeting.

"The calculated bundled prices are a single price for patients that would cover initial mammography screening and all subsequent imaging screening and diagnostic testing for either 364 days after the initial screen or a referral for biopsy or positive cancer diagnosis," said Danny Hughes, PhD, senior director for health policy research and senior research fellow, in a statement.

Practices can enter their own utilization and local pricing data to estimate bundled prices for both public and commercial insurers. Practices can also choose which services to include in a bundle by assigning values of 0 to any services in the tool they wish to exclude.

The tool was developed using carrier claims data from the U.S. Centers for Medicare and Medicaid Services (CMS) 5% Research Identifiable Files from 2013-2015, the most recent years available.

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