ACR questions proposed Medicare imaging pay cuts

The American College of Radiology is planning to "express its concerns" about a proposal by the U.S. Centers for Medicare and Medicaid Services (CMS) to reduce technical component payments for multiple imaging services on contiguous body parts.

In its proposal, CMS has identified 11 families of contiguous area, single-modality imaging that would now be paid as follows: When two or more procedures in the same family are performed in a single session, the first would be paid in full and a discount of 50% would be applied to subsequent procedures.

For example, the rule would apply to the family of CT procedures including CT of the thorax, pelvis, abdomen, CT angiography of those regions, and CT colonography (virtual colonoscopy) performed in a single session. A list of the 115 affected CPT codes, grouped by family, is posted on the ACR Web site.

CMS announced its plans on July 18 and will publish them in the July 26 Federal Register. In response, the ACR announced last week that it would "express its concerns and comments" to CMS during the formal comment period.

"This proposed rule assumes that there are economies in the technical component when procedures in the same family are performed in the same session, and that these economies are identical in all families. The ACR does not agree with these assumptions," the college noted.

CMS will accept comments on its proposal through Friday, September 16, 2005. A final rule is scheduled for publication by November 1, 2005.

By Tracie L. Thompson staff writer
July 27, 2005

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