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Physician Pay Wars' Winners and Losers

Cheryl Clark, for HealthLeaders Media, November 5, 2012

Neurology groups are disappointed. Radiology specialists are upset and even angry. But family physicians and internal medicine doctors are delighted.

Those were some responses hours after the Centers for Medicare & Medicaid Services on Thursday issued its 1,362-page final rule of fee schedules for 57 physician and other specialty provider groups for calendar year 2013.

"These are arbitrary cuts, and they make no sense," says Geraldine McGinty, MD, chairwoman of the American College of Radiology Economics Commission, about the schedule's 3% reimbursement cut for radiologists.

She notes that it is the third time imaging services have been cut since the Deficit Reduction Act of 2005 slashed payments.

Embedded in the new rule is the multiple procedure payment reduction policy, or MPRP, which limits a radiologist to 75% of reimbursement if he or she reads an image of a patient who has already had another imaging study performed and read by a different radiologist in the same group in the same session.

"If I read a brain MRI, and my partner reads an abdominal CT on the same patient, one of us is going to be paid 75%," McGinty says. "That's arbitrary because there's no meaningful efficiency" in these two services.

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