CMS has significantly cut interventional radiology reimbursement over the past decade
The Centers for Medicare & Medicaid Services has significantly cut interventional radiology reimbursement over the past decade. And members of the profession must help build awareness of this trend to help reverse these losses, according to an analysis published Wednesday.
Between 2012 and 2020, average unadjusted procedure pay for the specialty fell nearly 7%. But when factoring in inflation, losses leapt to almost 19%, University of Rochester Medical Center experts wrote in the Journal of Vascular Interventional Radiology.
IR certainly wasn’t alone, as neuro, plastic, general and orthopedic surgery have all demonstrated pay decreases during the same time, as has diagnostic radiology. But these numbers warrant further discussion and analysis as the subspecialty hopes to flourish in the coming years, the authors advised.
“Knowledge of these trends is critically important for practicing interventional radiologists, leaders within the field and legislators, who may play a role in formulating future reimbursement schedules for IR,” Derrek Schartz, MD, and Emily Young, MD, with URMC’s Department of Imaging Sciences, wrote Jan. 13. “These data may be used to help support more amenable reimbursement plans to sustain and facilitate the growth of the specialty.”
For the analysis, the authors utilized CMS’ Physician Fee Schedule look-up tool to pull data from 20 common IR procedures. Those included endovenous ablation of an incompetent vein, tunneled central venous catheter placement, and insertion and removal of intravascular vena cava filters, just to name a few.
They discovered that those procedures that had a change to their CPT code demonstrated a larger reduction in mean-adjusted percentage change compared to those that did not (29.4% versus 16%). Percutaneous nephrostomy tube placement experienced the biggest drop when adjusting for inflation at 43%. Meanwhile, percutaneous drain placement for visceral abscess was the only procedure in the analysis that saw an increase in pay, at 7.5%. And across all procedures, there was a nearly 3% mean decrease each year.
The authors did not explore reasons for the declines; however, they did note that procedure bundling may have been a factor for those that underwent code changes. These declines came for IR, despite Congress implementing the Medicare Access and Children’s Health Insurance Program Reauthorization Act in 2015 to bolster physician payment.
You can read more of Schartz and Young’s findings in JVIR here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.