On Thursday, The Centers for Medicare and Medicaid Services released the 2015 Medicare Physician Fee Schedule and they proposed a 2 percent drop in reimbursement for radiology. The proposal also includes an 8 percent cut for radiation therapy centers and a 4 percent cut for radiation oncology.
It wasn’t all grim news however with nuclear medicine, cardiology and family practices expected to get a slight bump in reimbursement increasing 1 percent, with reimbursement for family practices increasing 2 percent.
The agency also proposed to delete the mammography G-codes and instead pay all mammography with the CPT codes. However, since the CPT codes have not been reviewed recently, CMS believes that they may be misvalued and is calling for the Relative Value Scale Update Committee and other stakeholders to review the services. In the meantime, CMS is proposing to value the CPT codes with the relative value units that were established for the G-codes, which would lead to a temporary reimbursement increase.
The agency also proposed to include 80 additional CPT codes that have not been reviewed since 2009 in their list of potentially misvalued codes. About 20 of the codes concern radiology including interventional radiology, mammography, MR of the abdomen, CT of the thorax, chest X-ray, X-ray of the knee, radiation therapy planning and radiation treatment aids.
Questions revolve around whether Medicare should pay under the PFS when physicians conduct subsequent interpretations of existing images and whether the uncertainty over the payment would stop physicians from seeking out existing images when not conducting a new study would lead to Medicare savings.
CMS will be accepting comments for the proposal through September 2nd.
