Only 10 radiology practices completed survey used to adjust Medicare payments

The American College of Radiology says it urgently needs more radiologists to fill out the American Medical Association (AMA) Physician Practice Information Survey (PPIS) because it will be used to update how Medicare reimburses doctors. As of the middle of May, only 10 radiology practices had filled out the survey.

"Results from the survey play a major role in establishing accurate practice cost data for radiology and other specialties. It will have a large impact on physician payment," the ACR explained a statement this past week.

The PPIS aims to collect practice cost information for radiologists and other medical specialties and share that information with the Centers for Medicare and Medicaid Services (CMS). ACR said data currently used by CMS in the Medicare Physician Fee Schedule has not been updated in over 15 years.

The AMA, in coordination with Mathematica, has been promoting the survey since July 2023. Of the more than 400 radiology practices sampled, less than 10 practices have completed the survey. The ACR said the deadline to complete the survey is also rapidly approaching.

"The American College of Radiology strongly encourages members and their practices that have received the survey to complete it as soon as possible," the ACR said in a statement to its members. 

The AMA reached out to the physicians of sampled practices to alert them that their practices have been selected to complete the survey. The physicians will only receive the physician survey once their practice has submitted the practice survey.

ACR is asking members to check your email inboxes, including junk and spam for an email from ppisurvey@mathematica-mpr.com or physicianhourssurvey@mathematica-mpr.com. They also should check their physical mailboxes for a USPS mail packet from Mathematica.

The ACR also said radiologists should remind their business managers and financial experts to see if they were sent the survey

Why the PPI survey is important for physician reimbursements

The AMA said that, after accounting for inflation in practice costs, Medicare physician payments declined 26% from 2001 to 2023. The Medicare physician payment schedule, which is also used by many private insurance payers, relies on 2006 cost information to develop practice expense relative values. This data from the Medicare Economic Index is what is used to calculate physician payments. 

"Given that the U.S. economy and healthcare system have undergone substantial changes since that time, including inflation and the widespread adoption of EHRs and other IT systems, practice-expense payments no longer accurately reflect the relative resources that are typically required to provide physician services," the AMA said in a statement. 

The ACR is one of 173 physician medical groups urging members to its members to please fill out the survey so reimbursements can more accurately reflect the current, true costs for radiology practices. 

Garbage-in-garbage out for radiology RVU calculation data

Incoming Radiology Business Management Association Co-executive Director Linda Wilgus, CPA, CMPE, spoke with Radiology Business in a previous interview about the PPI survey and offered a good overview of its importance and how it is used in calculating radiology reimbursements.

Watch the video interview with Wilgus

The last PPIS data for radiology reimbursements was collected in 2007, when only 105 radiology practices participated. Of those responses, only 21 filled out the entire survey and acknowledged they had direct practice expenses in an office setting. Wilgus said the remainder of the responses were from academic radiologists who reported no expenses, which resulted in the dataset being populated by a lot of zeros. This is the data used to calculate radiology reimbursements since the 2010 MPFS.

"Radiology was significantly under represented in the survey and we have been reimbursed by a flawed model since 2010," Wilgus explained. "We have an opportunity now to fix this flawed reimbursement model." 

She stressed the importance if a radiologist gets this survey to ensure it gets to the right person in their organization so it can be filled out with the proper data. Wilgus said the financial information needed is very detailed, which is why it is important to get the survey to the correct person. 

It is possible that the AMA does not have the correct contact information for a practice’s financial expert. If they need the survey link, the ACR said they can contact the AMA’s consultant, Mathematica, at PPISurvey@mathematica-mpr.com.

Dave Fornell is a digital editor with Cardiovascular Business and Radiology Business magazines. He has been covering healthcare for more than 16 years.

Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com

Around the web

Prior to the final proposal’s release, the American College of Radiology reached out to CMS to offer its recommendations on payment rates for five out of the six the new codes.

“Before these CPT codes there was no real acknowledgment of the additional burden borne by the providers who accepted these patients."

The new images were captured at the European Synchrotron Radiation Facility using hierarchical phase-contrast tomography. One specialist called them "Google Earth for the human heart." 

Trimed Popup
Trimed Popup