CMS rule seeks to reduce CT and MR reimbursements

by Loren Bonner, DOTmed News Online Editor | July 22, 2013
The Centers for Medicare and Medicaid Services issued its 2014 rule for hospital outpatient services, and imaging stakeholders are not looking upon it favorably.

The proposed rule, which will be finalized in November, seeks to use separate cost centers for CT and MR and will affect imaging payments.

"Because these imaging cost centers do not accurately capture the total costs of providing CT and MR services, this proposal will undervalue the costs of these vital services and lead to substantial Medicare reimbursement cuts for these imaging modalities in the hospital setting," said Gail Rodriguez, executive director of MITA, in a statement.

Essentially, CMS is proposing to divide the diagnostic radiology hospital cost center into three separate buckets for MR, CT, and "other" diagnostic radiology services.

"This is really going to affect the payment for CT and MR, in particular, CT in the hospital setting. And a way to gauge that is that a CT will be paid the same as an X-ray," said Laurel Sweeney, senior director of global reimbursement for Philips Healthcare, to DOTmed News.

Additionally, because the Deficit Reduction Act imposes caps on reimbursement for non-hospital imaging services, drops in hospital outpatient payments will result in similar cuts to non-hospital reimbursement for imaging services, according to MITA. "In fact, analysis of Medicare data shows that this policy would result in payment cuts to 65 non-hospital imaging services. MITA encourages CMS to reconsider this policy, to ensure that patients continue to have access to the right scan at the right time," said Rodriguez.

Industry stakeholders are working with CMS on the issue. The comment period on the proposed rule ends September 1.

Norman Meyers

Provbider costs for CT and MRI increased by ACR

July 25, 2013 04:42

ACR requirements for accreditation, equipment maintenance payments, technologist requirements, testing requirements costs, and physicist reports, have addeded substantial costs to operating facilities providing CT and MRI exams. State and Federal government have been convinced, wrongly, of the need for ACR to be the monitor of radiology equipment.

Radiologist approvals of scans have been eliminated as the normal and realistic means of constant daily testing of the equipment and the work of technologists.

ACR has become a money-making institution through exploitation of its membership name and gevernment and insurance companies' forced price reductions for all radiology services.

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