Proposed 2012 Fee Schedule: Imaging Interpretations to Witness Further Cuts

Radiologists and oncologists will witness a four percent cut to their total Medicare reimbursement in 2012; radiation therapy centers could face five percent cuts.

This proposed rule addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.

On July 1, the Centers for Medicare and Medicaid went ahead with its proposed Medicare Physician Fee Schedule for 2012. And news is the bad run for imaging practices continues.

Background: Over the past five years, diagnostic imaging has witnessed significant cuts. So if the proposed rule becomes final, the radiologists and all practitioners who interpret diagnostic imaging tests will face cuts. “This payment cut would have serious consequences and we cannot and will not allow it to happen. That's why the President's budget and his fiscal framework call for averting these cuts and why we are determined to pass and implement a permanent and sustainable fix," said Donald M. Berwick, MD, the CMS administrator in the agency's release.

Imaging pay cuts

If the proposed rule is finalized, imaging pay will be badly hit. Presently, you get 100 percent of the global fee for your primary study when you carry out multiple radiological procedures that are within the same family. But then for the second and subsequent studies, you collect 100 percent of the professional component (PC) and 50 percent of the technical component (TC).

In 2012, the agency is likely to slash both the TC and PC of subsequent radiological procedures by 50 percent.

Further cuts: In fact, the proposed rule indicates that payment cuts could be even deeper in 2013.

Specialties likely to gain if the proposed rule 2012 becomes final

Specialties like anesthesiology, ophthalmology, neurology, and physical medicine are likely to witness a 2 percent raise in Medicare pay for 2012 if all of the proposals are finalized.