Although the Centers for Medicare and Medicaid Services (CMS) could have proposed creating a 50% multiple procedure payment reduction (MPPR) on the professional component of advanced imaging (as it did in 2011), or elected to expand the MPPR to all forms of imaging, it decided to drop the issue for this year instead.
The 2014 Medicare Physician Fee Schedule proposed rule, which came out July 8, leaves things as they stood last year with a 25% MPPR on the professional component of advanced imaging procedures such as MRIs and CTs that are also the most costly. On its website, the American College of Radiology (ACR) said it was “pleased” that CMS did not expand the MPPR to all other imaging exams and credited its own meetings with CMS on the issue, as well as political pressure from Congress, as two of the possible reasons why CMS decided against using this particular way to reduce reimbursement on imaging this year. (Imaging reimbursement cuts were made in the HOPPS rule. Learn more here.)
The ACR is lobbying to remove the MPPR on the professional component of imaging all together through legislation. Because each imaging study produces its own set of images requiring individual interpretation, radiologists are ethically and professionally obligated to expend the same amount of time and effort interpreting each individual image, whether the images were created on the same day or on two different days. A peer-reviewed study frequently referenced by the ACR showed that professional component efficiencies vary across modalities and range from a minimum of 2.96% for CT to a maximum of 5.45% for ultrasound.
In addition, the ACR has argued that the MPPR cuts reimbursement for treatment of the sickest patients who need multiple imaging studies done at one time because of a very severe or even catastrophic accident or illness.
Currently, the Diagnostic Imaging Services Protection Act proposed legislation to remove the MPPR on the professional component has 147 co-sponsors on the House of Representatives bill (H.R. 846) and 11 on the Senate bill (S. 623).
To see if your Congressional representatives have signed on to the bill, click here. Resources for either thanking a representative for their support or asking them to sign on are available to all through the ACR’s website issues page.