Experts issued detailed breakdowns of how recent changes to the Medicare Physician Fee Schedule will impact radiology through the rest of the year.
President Joe Biden signed the 2024 Consolidated Appropriations Act into law on March 9, scaling back the original 3.37% reduction to the conversion factor. With the adjustment, the CF is now 1.77% lower than it was in 2023, at $33.2875, consulting firm Healthcare Administrative Partners noted.
Claims submitted after the signing date through Dec. 31 will use this new rate, depending on whether lawmakers take further action.
“Note that all of these provisions are temporary, limited time adjustments,” HAP VP of Client Services Sandy Coffta wrote March 27. “Several bills are pending in Congress that would make more permanent corrections to the Medicare pricing formula, but as of this writing none are in active discussion.”
On the global reimbursement side, breast tomosynthesis (G0279) has been cut about 11.72% for 2024, with many high-volume procedures also facing reductions larger than 1.77%. Those include screening mammography (-2.02%), ultrasound of the abdomen (-2.33%) and MRI of the lumbar spine (-2.76%). Limited extremity ultrasound (76882) was the only service to see a significant increase in global reimbursement, at 48.13%.
For the professional component, chest X-ray (71045) saw one of the biggest reductions at -5.55%, followed by ultrasound of the abdomen (-4.11%) and breast tomosynthesis (-4.05%). Based on an overall volume-weighted analysis, HAP expects the professional component will drop 2.7% while the global side will drop 2.5%, based on the same volume as last year.
The American College of Radiology also released impact tables on Wednesday, illustrating how the MPFS updates affect specific services delivered by the specialty. ACR’s analysis includes 70,000 series CPT codes and the non-70,000 CPT codes billed by radiologists and IR specialists.
You can find ACR’s full breakdown here and the analysis from Healthcare Administrative Partners 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.