Deep dive finds more for radiologists to dislike in 2021 Medicare Physician Fee Schedule
A new analysis of the 2021 Medicare Physician Fee Schedule is unearthing more for radiologists to dislike about the proposal.
Consulting firm Healthcare Administrative Partners shared its deep dive on Friday, highlighting sizable slashes to doc pay when the calendar flips. Those include a 11% hit to diagnostic radiology, 9% on the interventional side, and 8% for nuclear medicine.
While those numbers have already been circulated, Pennsylvania-based HAP also drilled down to the impact on high-volume radiology procedures and noted drops as high as 18% in 2021. The cuts follow the inclusion of a pay boost for evaluation and management services, which necessitates budget balancing elsewhere that advocates say will come out of the pockets of rads and other physicians.
“Many specialties, including radiology, will see a significant cut in Medicare reimbursement in 2021 if the MPFS Proposed Rule is applied without a change to the budget neutrality requirement in the law,” Sandy Coffta, VP of client services for HAP, wrote in the analysis. “The proposed rule is subject to comment from the public and interested organizations that will potentially modify its proposals,” she added later.
Coffta and colleagues made their determinations using their payment database and calculating the impact on the most popular procedures. She noted that the hospital professional component of payment would drop by at least 10% for an extracranial bilateral study, using a duplex doppler, to as high as 18% for CT of the thorax without dye. Most cuts would fall into the 11%-12% range.
Meanwhile, the range of reductions is much greater for providers operating in freestanding imaging centers, with cuts as low as 1% for some x-rays and 15% for CT. MRI would drop 8% while ultrasound would fall by as much as 7%, and the overall drop may be lower than CMS’ 11% estimate, Coffta wrote.
You can read much more of the 2021 MPFS—including its impact on the Quality Payment Program and appropriate use criteria—here. A bipartisan group of House members is also advocating against these cuts, calling them “reckless” and “devastating for providers.”
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.