ACR sees benefits for radiology in the 2022 HOPPS rule

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The U.S. Centers for Medicare and Medicaid Services' (CMS) on November 2 released its final rule for the 2022 Medicare Hospital Outpatient Prospective Payment System (HOPPS), and the American College of Radiology (ACR) sees some benefits for radiology.

CMS plans to boost the conversion factor by 2% to $84.18 for 2022. It will also increase the reimbursement rate for hospital outpatient CT lung cancer screening -- a win for the ACR, which has lodged concerns about inadequate payments for low-dose CT screening for the disease for years, it said. The new reimbursement rate will be $111.19, up 37.4% from the current rate of $80.90 (CPT code 71271).

"New U.S. Preventive Services Task Force guidelines have nearly doubled the number of people eligible for such screening," the ACR said. "However, less than 15% of Americans who met previous USPSTF lung cancer screening criteria are tested. Improved payment may bolster lung cancer screening availability."

CMS has also increased payment for "medical physics dose evaluation for radiation exposure that exceeds institutional review threshold," (CPT code 76145) from $130.19 to $345.85, and it has changed its radiation oncology model to cover 30% of all radiation oncology "episodes," according to the ACR.

The college plans to continue to review the final rule and expects to post a thorough summary soon, it said.

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