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8/9/2006 - The Centers for Medicare and Medicaid Services (CMS) announced that it will not, as previously planned, seek an additional 25% technical reimbursement cut for imaging on contiguous body parts in the same session, as part of the Medicare Physician Fee Schedule (MPFS) proposed rule for 2007, but will maintain the current 25% cut imposed on January 1, 2006.

The proposed rule states, "Given the expected interaction between the multiple procedure imaging policy and the further imaging payment reductions mandated by section 5102(b) of the DRA...along with the new information we have received from the ACR on the multiple imaging procedure policy as it applies to common combinations of imaging services, we believe it would be prudent to maintain the multiple imaging payment reduction at its current 25% level while we continue to examine the appropriate payment levels."

The proposed rule also makes clear that the 25% cut for contiguous imaging would be taken prior to any reduction resulting from the Deficit Reduction Act of 2005 mandate that out of hospital imaging be reimbursed at the lesser of the Medicare Physician Fee Schedule or the Hospital Outpatient Prospective Payment, should the DRA imaging cuts be allowed to take effect in January 2007. This method of calculation would likely reduce the impact of these tandem cuts.

The proposed rule also states that PET and radiation oncology would be included in the DRA imaging reimbursement cuts. However, only two radiation oncology codes (77417 and 77421) will be affected.

The ACR, along with other members of the Access to Medicare Imaging Coalition, has spearheaded an effort resulting in the introduction of the Access to Medicare Imaging Act (HR 5704 and S. 3795) into the US House and Senate, which seeks a 2-year moratorium on these cuts pending a Government Accountability Office study on the effects of these drastic cuts on patient access to care.

The proposed rule also calls for a 5.1% across-the-board physician reimbursement cut in the conversion factor mandated by the sustainable growth rate formula (SGR). The SGR formula compares the actual growth rate of physician services in spending to a target rate. If the actual rate exceeds the target, the update is decreased.

The comment period on the proposed rule for 2007 is now open and extends through October 10. The ACR will, of course submit comments and keep members informed as to any new developments.