Radiologists Push Back on Reimbursement Cuts

John Commins, April 12, 2013

Radiologists are complaining that their specialty has been the target of too many sticks and not enough carrots as the federal government looks for ways to control cost growth in Medicare.

The latest skirmish is pitched around the Centers for Medicare & Medicaid Services' 25% multiple procedure payment reduction to Medicare reimbursements for interpretations of advanced diagnostic imaging scans performed on the same patient in the same session. The rule, which took effect in January, applies across all physicians in a practice.

Geraldine McGinty, MD, chair of the American College of Radiology Commission on Economics, is the co-author of a study that she says refutes the government's assumptions that significant efficiencies in physician interpretation and diagnosis are gained when different providers interpret different medical imaging scans performed on the same patient.

"Medicare believes there are efficiencies so that when a subsequent service is performed, that the physician that is furnishing that subsequent service does not have to make the same effort they would have to make if there were no other services performed in the same session," McGinty says. "We don't believe that that is true and our paper clearly shows that it is not."

The study appears this week in the online edition of the Journal of the American College of Radiology.

The rule does not affect the number of scans ordered; only interpretation of scans already performed, and has been expanded to physical therapy, cardiovascular, and ophthalmology technical services as well.

John Commins

John Commins is a senior editor at HealthLeaders Media.

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